| Goodendos Llc | |
|
41 Fairpoint Dr Ste B Gulf Breeze FL 32561-4380 | |
| (850) 733-3636 | |
| (448) 444-5678 |
| Full Name | Goodendos Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 41 Fairpoint Dr Ste B, Gulf Breeze, Florida |
| Authorized Official Name and Position | Michael Arthur Hennigan (OWNER) |
| Authorized Official Contact | 8507733636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodendos Llc 41 Fairpoint Dr Ste B Gulf Breeze FL 32561-4380 Ph: (850) 733-3636 | Goodendos Llc 41 Fairpoint Dr Ste B Gulf Breeze FL 32561-4380 Ph: (850) 733-3636 |
| NPI Number | 1265194708 |
|---|---|
| Provider Enumeration Date | 10/12/2021 |
| Last Update Date | 12/29/2021 |
| Medicare PECOS PAC ID | 3678965217 |
|---|---|
| Medicare Enrollment ID | O20220111002904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265194708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Michael A Hennigan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003971839 PECOS PAC ID: 3971405135 Enrollment ID: I20171003005108 |
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Coastal Medical Integration Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3481 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 Phone: 850-903-1708 | |
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