Basic Information
| Provider Information | |||||||||
| NPI: | 1710417365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GODIL | ||||||||
| FirstName: | RANIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3752 EDINGTON DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957427829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608557831 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11375 CORTEZ BLVD | ||||||||
| Address2: | |||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346135409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525922753 | ||||||||
| FaxNumber: | 3525916317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2017 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA10831800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | TRN24985 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 175090 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.