Individual
MR. SAMUEL ERWIN GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, CPHT
Contact information
Practice address
7290 55TH AVE E, BRADENTON, FL 34203-8002
(941) 727-8412
(941) 727-8195
Mailing address
7290 55TH AVE E, BRADENTON, FL 34203-8002
(941) 727-8412
(941) 727-8195
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT00529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4701-0109-0250-425
PTCB
—
Enumeration date
11/16/2010
Last updated
11/16/2010
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