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General NPI Number Information
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NPI Number | 1598628547
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Entity Type | Individual
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Provider Name | ANDREW GOODWIN
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Gender | Male
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 13880 SHELL POINT PLZ
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City | FORT MYERS
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State | FL
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Zip | 33908-3503
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Country | US
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Telephone | 239-415-5477
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Fax |
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Provider Business Mailing Address
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Address Line | 11141 EVERBLADES PKWY APT 212
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City | ESTERO
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State | FL
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Zip | 33928-9552
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA32656
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License Number State | FL
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