Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME63425 | FL |
NPI | 1114926904 |
---|---|
Provider Name | Howard M Goodman |
First Address | Fort Myers, FL 33916-2216 |
Second Address | West Palm Beach, FL 33401-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 10/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372903600 | (05) | FL |
B74147 | (02) | FL |