Provider Demographics
NPI:1487168688
Name:GOODWIN, MONDONA (DO)
Entity type:Individual
Prefix:
First Name:MONDONA
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MONDONA
Other - Middle Name:
Other - Last Name:SHAHROKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:90 SW 91ST AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2559
Mailing Address - Country:US
Mailing Address - Phone:443-165-4580
Mailing Address - Fax:
Practice Address - Street 1:WOODLAND HILLS MEDICAL CENTER
Practice Address - Street 2:5601 DE SOTO AVE
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO4386207R00000X
CA20A16413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine