MEDICARE: DR. JENNIFER LYNN GOLDIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME82356	FL
2	207Q00000X	Family Medicine Physician	35077156G	OH

General Provider Information

NPI Number	:	1952340374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER LYNN GOLDIN M.D.

Provider Business Mailing Address
First Line	:	1277 N SEMORAN BLVD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-3573
Country	:	US
Telephone Number	:	407-447-7550
Fax Number	:	407-447-7551

Provider Business Practice Location Address
First Line	:	1277 N SEMORAN BLVD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-3573
Country	:	US
Telephone Number	:	407-447-7550
Fax Number	:	407-447-7551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/20/2007

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