Provider Demographics
NPI:1326552431
Name:GOYA, CESAR LEONEL
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:LEONEL
Last Name:GOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 SW 134TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1128
Mailing Address - Country:US
Mailing Address - Phone:786-499-1318
Mailing Address - Fax:
Practice Address - Street 1:10920 W FLAGLER ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1243
Practice Address - Country:US
Practice Address - Phone:786-623-3915
Practice Address - Fax:786-623-3916
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9354499363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner