Doctor Name: | VINCENT GO |
NPI Number: | 1346365368 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME 43940 |
Business Practice Address: | 13801 White Gardenia Way Fort Myers, FL - 339125678 |
Business Phone Number: | 2396436615 |
Business Fax Number: | |
Mailing Address: | 13801 White Gardenia Way, FORT MYERS |
State: | FL |
Postal Code: | 339125678 |
Phone Number: | 2396436615 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 43940 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |