George Emil Goddridge

Primary specialty

ContractorTaxonomy code 171W00000X

License

JF130454 Issued in FL

Practice address

7777 Grande St
Sunrise, FL 33351-6313

Phone

(954) 547-2675

NPI assigned

Jul 25, 2019

Last updated

Jul 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1710531942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 GRANDE ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516313",
            "telephone_number": "954-547-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 GRANDE ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516313",
            "telephone_number": "954-547-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDRIDGE",
        "first_name": "GEORGE",
        "middle_name": "EMIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": "FL",
            "license": "JF130454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.