Goodwin, Frederick Mark

Goodwin, Frederick Mark is an individual health care provider with primary practice located at 2000 E Edgewood Dr Suite 112, Lakeland FL 33803-3653. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Goodwin, Frederick Mark can be contacted via phone (863) 666-3436.

Contact Information

Primary practice address
2000 E Edgewood Dr Suite 112 Lakeland FL 33803-3653
Phone: (863) 666-3436
Fax: (863) 667-3550
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME00013382 Florida

Profile Details

NPI number 1568556504
LBN Legal business name Goodwin, Frederick Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Mar 6th, 2015 - about 11 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 1568556504 NPPES
Other 207661 AVMED
Other 200018451 AVMED
Other 0905403 AVMED
Other 4815734002 AVMED
Other 0625534 AVMED
Other 25133 AVMED
Other 25133Z AVMED
MEDICAID 375203800 AVMED

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