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Individual

DR. KEVIN LEE GOODHUE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
730 SOUTH ORANGE BLOSSOM TRAIL, APOPKA, FL 32703
(407) 880-0335
Mailing address
730 SOUTH ORANGE BLOSSOM TRAIL, APOPKA, FL 32703
(407) 880-0335
(407) 880-6732

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1677
SC
152W00000X
Optometrist
Primary
OPC4705
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009942600
FL
Enumeration date
01/10/2012
Last updated
11/07/2016
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