Individual
DR. GARY GOODENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4121
(386) 258-4802
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4121
(386) 258-4802
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME44693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252074500
—
FL
01
—
ME44693
STATE MEDICAL LICENSE
FL
Enumeration date
12/06/2006
Last updated
04/05/2010
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