Individual
DR. TERESA L GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3700 W SOVEREIGN PATH, LECANTO, FL 34461-8071
(352) 527-0068
Mailing address
8631 E GREENOCK DR, INVERNESS, FL 34450-1780
(352) 527-0068
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP2012692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740252030
NPI
FL
01
—
40474
HEALTHEASE
FL
01
—
5935028431021
TRICARE
FL
01
—
ARNP2012692
LICENSE
FL
Enumeration date
02/02/2006
Last updated
10/03/2007
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