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NPI Code Detail

MEDICARE: SOFIA ROSE GOODWIN

MEDICARE: SOFIA ROSE GOODWIN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1912835687
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA ROSE GOODWIN
Provider Business Mailing Address
First Line : 530 S MAIN ST
Second Line :
City : LIMA
State : OH
Zip : 45804-1500
Country : US
Telephone Number : 419-222-1168
Fax Number :
Provider Business Practice Location Address
First Line : 530 S MAIN ST
Second Line :
City : LIMA
State : OH
Zip : 45804-1240
Country : US
Telephone Number : 419-222-1168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ SOFIA ROSE GOODWIN ” Practice Location

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