MEDICARE: DR. RICHARD M GOODMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	ME21487	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	408111337	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	591322663A	OTHER	HUMANA
2	92713	OTHER	HEALTH OPTIONS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5487107	OTHER	FIRST HEATLH
5	92713	OTHER	BLUE CROSS BLUE SHIELD
7	2045636	OTHER	AETNA
8	20544	OTHER	NEIGHBORHOOD HEALTH PLAN
9	1117963	OTHER	CIGNA

General Provider Information

NPI Number	:	1164411799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD M GOODMAN MD

Provider Business Mailing Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	SUITE 303
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-466-0030
Fax Number	:	305-466-4755

Provider Business Practice Location Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	SUITE 303
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-466-0030
Fax Number	:	305-466-4755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	01/26/2011

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Directions to “ DR. RICHARD M GOODMAN MD” Practice Location

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