Healthcare Provider Details

I. General information

NPI: 1588856421
Provider Name (Legal Business Name): NATASHA GOODEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 N ARMENIA AVE SUITE 200
TAMPA FL
33607-6448
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 813-876-0914
  • Fax: 813-876-9198
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME101116
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: