Goodman, Mark S

Goodman, Mark S is an individual health care provider with primary practice located at 1611 Nw 12Th Ave Box 016960 M851, Miami FL 33136-1005. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Goodman, Mark S can be contacted via phone (305) 585-1111.

Contact Information

Primary practice address
1611 Nw 12Th Ave Box 016960 M851 Miami FL 33136-1005
Phone: (305) 585-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X ME51535 Florida
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X ME51535 Florida

Profile Details

NPI number 1669400545
LBN Legal business name Goodman, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Feb 20th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669400545 NPPES
Florida MEDICAID 0611158-00

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