Healthcare Provider Details

I. General information

NPI: 1841407301
Provider Name (Legal Business Name): MATTHEW D GOODWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 N FEDERAL HWY
BOCA RATON FL
33431-5133
US

IV. Provider business mailing address

4700 EXCHANGE CT STE 110
BOCA RATON FL
33431-4450
US

V. Phone/Fax

Practice location:
  • Phone: 561-362-8000
  • Fax: 561-447-6806
Mailing address:
  • Phone: 561-948-0291
  • Fax: 561-859-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME97906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: