Individual
DR. JEFFREY ALAN GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1879 NIGHTINGALE LN STE C2, TAVARES, FL 32778-4363
(352) 742-7776
(352) 742-7750
Mailing address
1879 NIGHTINGALE LN STE C2, TAVARES, FL 32778-4363
(352) 745-7776
(352) 742-7750
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME66294
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10008741
MEDICARE RAILROAD
FL
01
—
25425
BLUE CROSS
FL
05
—
375405700
—
FL
Enumeration date
09/14/2006
Last updated
03/27/2019
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