Organization
R THAD GOODWIN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN THAD GOODWIN M.D. (PRESIDENT)
(239) 939-3937
Entity
Organization
Contact information
Practice address
1510 ROYAL PALM SQUARE BLVD, STE 106, FORT MYERS, FL 33919-1068
(239) 939-3937
(239) 275-8045
Mailing address
1510 ROYAL PALM SQUARE BLVD, STE 106, FORT MYERS, FL 33919-1068
(239) 939-3937
(239) 275-8045
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0037950
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042931700
—
FL
Enumeration date
10/24/2007
Last updated
10/04/2011
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