Individual
DR. FREDERICK MARK GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 E EDGEWOOD DR, SUITE 112, LAKELAND, FL 33803-3653
(863) 666-3436
(863) 667-3550
Mailing address
2000 E EDGEWOOD DR, SUITE 112, LAKELAND, FL 33803-3653
(863) 666-3436
(863) 666-7355
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME00013382
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0625534
AETNA
FL
01
—
0905403
UNITED HEALTH CARE
—
01
—
200018451
MEDICARE RAILROAD
—
01
—
207661
AVMED
—
01
—
25133
BLUE SHIELD
FL
01
—
25133Z
MEDICARE P-TAN
FL
05
—
375203800
—
FL
01
—
4815734002
CIGNA
—
Enumeration date
10/03/2006
Last updated
03/06/2015
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