MEDICARE: DR. NEIL F GOODMAN M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME0021486	FL

General Provider Information

NPI Number	:	1356305783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL F GOODMAN M.D.

Provider Business Mailing Address
First Line	:	9150 SW 87TH AVE
Second Line	:	SUITE 210
City	:	MIAMI
State	:	FL
Zip	:	33176-2319
Country	:	US
Telephone Number	:	305-595-6855
Fax Number	:	305-595-4846

Provider Business Practice Location Address
First Line	:	9150 SW 87TH AVE
Second Line	:	SUITE 210
City	:	MIAMI
State	:	FL
Zip	:	33176-2319
Country	:	US
Telephone Number	:	305-595-6855
Fax Number	:	305-595-4846

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	07/29/2010

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