# F MARK GOODWIN MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeland Orthopaedic Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194801316
- **Authorized official:** FREDERICK MARK GOODWIN MD (PRESIDENT)
- **Authorized official phone:** (863) 688-8401

## Contact information

- **Practice address:** 2000 E EDGEWOOD DR, SUITE 110, LAKELAND, FL 33803-3653
- **Practice address phone:** (863) 688-8401
- **Practice address fax:** (863) 682-3659
- **Mailing address:** PO BOX 907, LAKELAND, FL 33802-0907
- **Mailing address phone:** (863) 688-8401
- **Mailing address fax:** (863) 682-3659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 04/12/2012