Goodwillus Medical Clinic, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME56548 Issued in FL

Legal business name

GOODWILLUS MEDICAL CLINIC, LLC

Practice address

7037 State Road 52
Hudson, FL 34667-6706

Phone

(727) 862-3600

Fax

(727) 862-8899

NPI assigned

Oct 8, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Adetola Adeyanju-Ishola

Title

President/Ceo

Phone

(727) 862-3600

Specialties & licenses 1

Addresses

Other names 1

• GOODWILLUS MEDICAL CLINIC LLC Other name

Locations

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1922318948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7037 STATE ROAD 52",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346676706",
            "telephone_number": "727-862-3600",
            "fax_number": "727-862-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7037 STATE ROAD 52",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346676706",
            "telephone_number": "727-862-3600",
            "fax_number": "727-862-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILLUS MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "ADEYANJU-ISHOLA",
        "authorized_official_first_name": "ADETOLA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "727-862-3600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME56548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOODWILLUS MEDICAL CLINIC LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicolas A Goldberg, MD
• Jose Gomez, MD
• Juan Gonzalez, MD
• Kenny Gonzalez
• Kenneth Edward Goodell, PTA
• Randy M Gordon, ARNP
• Thomas Canyon Gore, DO
• Muna Goyal, M.D
• Rajiva Goyal, M.D.
• Savannah L Grandy

• General Practice Physician in Hudson, FL
• Providers in Hudson, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.