Individual
MRS. JOYCE M GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
7751 BAYMEADOWS RD E STE H, JACKSONVILLE, FL 32256-5836
(904) 425-6963
(904) 674-0155
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101604
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020808200
—
FL
01
—
LP713
MEDICARE
FL
01
—
Y0Q73
BCBS
FL
Enumeration date
01/30/2006
Last updated
08/25/2020
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