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General NPI Number Information
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NPI Number | 1285138768
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Entity Type | Individual
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Provider Name | BRIAN GOODMAN
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Gender | Male
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 9970 CENTRAL PARK BLVD. SUITE 302
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City | BOCA RATON
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State | FL
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Zip | 33428-2237
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Country | US
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Telephone | 561-883-6400
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Fax | 305-279-5899
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Provider Business Mailing Address
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Address Line | 7800 SW 87TH AVE STE C-340
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City | MIAMI
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State | FL
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Zip | 33173-3570
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Country | US
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Telephone | 305-595-0109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME0161212
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | ME161212
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License Number State | FL
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