Individual
SANDRA GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1425 SE SAN SOVINA TER, PORT ST LUCIE, FL 34952-5727
(772) 919-5592
Mailing address
1425 SE SAN SOVINA TER, PORT ST LUCIE, FL 34952-5727
(772) 919-5592
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
RN 9241725
FL
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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