Healthcare Provider Details

I. General information

NPI: 1467520114
Provider Name (Legal Business Name): DORCAS B GOODMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DORCAS BONTRAGER

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11033 NW STATE ROAD 20
BRISTOL FL
32321-6406
US

IV. Provider business mailing address

403 E 11TH ST
PANAMA CITY FL
32401-3409
US

V. Phone/Fax

Practice location:
  • Phone: 850-643-1155
  • Fax:
Mailing address:
  • Phone: 850-643-1155
  • Fax: 850-643-1163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN678852
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberARNP678852
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: