Provider Demographics
NPI:1861562183
Name:GOAD, JAMES JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JUSTIN
Last Name:GOAD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:12953 PALMS WEST DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4990
Mailing Address - Country:US
Mailing Address - Phone:561-795-5130
Mailing Address - Fax:561-795-4160
Practice Address - Street 1:12953 PALMS WEST DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4990
Practice Address - Country:US
Practice Address - Phone:561-795-5130
Practice Address - Fax:561-795-4160
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2022-01-18
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Provider Licenses
StateLicense IDTaxonomies
FLME97137208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH96440OtherUPIN
FL277282500Medicaid
FL277282500Medicaid
FLH96440OtherUPIN