Individual
DR. SALVATORE R. GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 396-1630
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME35415
FL
207LP3000X
Pediatric Anesthesiology Physician
ME35415
FL
208000000X
Pediatrics Physician
Primary
ME35415
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000213804B
—
GA
05
—
065144301
—
FL
Enumeration date
08/10/2006
Last updated
09/11/2025
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