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Individual

DR. SHANIN LYNN GOODALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
4626 26TH ST W, BRADENTON, FL 34207
(941) 755-5535
Mailing address
4626 26TH ST W, BRADENTON, FL 34207-1701
(941) 755-5535

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1313
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4899680
GHI
FL
05
600454700
FL
Enumeration date
06/11/2006
Last updated
06/26/2019
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