Good Shepherd Medical Clinic PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME76767 Issued in FL

Legal business name

GOOD SHEPHERD MEDICAL CLINIC PA

Practice address

8425 Northcliffe Blvd
Suite 104
Spring Hill, FL 34606-1107

Phone

(352) 688-6346

Fax

(352) 688-9103

NPI assigned

Jun 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Roger B Lee, MD

Title

President

Phone

(352) 666-1011

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1245499300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 104",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-688-6346",
            "fax_number": "352-688-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 104",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-688-6346",
            "fax_number": "352-688-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-666-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CE7176",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Gonzalez Jr.
• Kristina Gonzalez, LMT
• Stephanie Gonzalez, ARNP
• Leslie Gooch, MS CCC SLP
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA

• Internal Medicine Physician in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.