Provider Demographics
NPI:1104485754
Name:GOTHRIG HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:GOTHRIG HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EGLINTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGAUD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PHD
Authorized Official - Phone:954-530-6558
Mailing Address - Street 1:2862 BELLAROSA CIR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1462
Mailing Address - Country:US
Mailing Address - Phone:757-613-5943
Mailing Address - Fax:
Practice Address - Street 1:2331 N STATE ROAD 7 STE 207
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3772
Practice Address - Country:US
Practice Address - Phone:954-530-6558
Practice Address - Fax:954-769-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty