KELLER & GOODMAN MD PA NPI 1225168701

NPI Information

  • NPI: 1225168701
  • Provider Name: KELLER & GOODMAN MD, PA
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Organization
  • CLIA Number: 10D2057102
  • Address: 1879 NIGHTINGALE LN
    SUITE C-2
    TAVARES, FL
    ZIP 32778
  • Phone: (352) 742-7776

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NPI Details

KELLER & GOODMAN MD, PA is a gastroenterology internal medicine in Tavares, FL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. KELLER & GOODMAN MD, PA NPI is 1225168701. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1879 NIGHTINGALE LN
SUITE C-2
TAVARES, FL
ZIP 32778-363
Phone: (352) 742-7776
Fax: (352) 742-7750

The provider's authorized official is Jeffrey Alan Goodman .
The authorized official title is Owner and has the following contact phone number (352) 742-7776.

The CLIA number assigned to this NPI record is 10D2057102 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 7/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyME66294FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
133071MEDICARE PINFLORIDA
2375405700MEDICAIDFLORIDA
325425OTHERBLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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