Provider Demographics
NPI:1265748644
Name:GOSWAMI, AYAN (DPM, FACPM)
Entity type:Individual
Prefix:DR
First Name:AYAN
Middle Name:
Last Name:GOSWAMI
Suffix:
Gender:M
Credentials:DPM, FACPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 PALM SPRINGS DR STE D
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7864
Mailing Address - Country:US
Mailing Address - Phone:321-300-3190
Mailing Address - Fax:
Practice Address - Street 1:660 PALM SPRINGS DR STE D
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7864
Practice Address - Country:US
Practice Address - Phone:321-300-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00317500213ES0103X
FLPO4060213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty