MEDICARE: DR. JAMIE ALAN GOODMAN D.C.

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	111N00000X	Chiropractor	CH7832	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	70157	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	619732	OTHER	FL	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1285694414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE ALAN GOODMAN D.C.

Provider Business Mailing Address
First Line	:	2206 CURLEW RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6823
Country	:	US
Telephone Number	:	727-772-7788
Fax Number	:	727-772-0400

Provider Business Practice Location Address
First Line	:	2206 CURLEW RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6823
Country	:	US
Telephone Number	:	727-772-7788
Fax Number	:	727-772-0400

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/17/2018

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