Individual
MICHAEL JON GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
1107 VENETIAN HARBOR DR NE, ST PETERSBURG, FL 33702-1916
(727) 421-8133
Mailing address
1107 VENETIAN HARBOR DR NE, ST PETERSBURG, FL 33702-1916
(727) 421-8133
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1913
FL
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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