Individual
MR. GARY THOMAS GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 BYPASS DR, SUITE 108, CLEARWATER, FL 33764-5078
(727) 643-9648
Mailing address
PO BOX 7388, ST PETERSBURG, FL 33734-7388
(727) 643-9648
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/17/2011
Last updated
01/17/2011
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