Provider Demographics
NPI:1588785315
Name:GOODMAN, JAMIE ARTHUR (DO)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ARTHUR
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:81990 OVERSEAS HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-3614
Mailing Address - Country:US
Mailing Address - Phone:305-664-2488
Mailing Address - Fax:305-664-2489
Practice Address - Street 1:81990 OVERSEAS HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3614
Practice Address - Country:US
Practice Address - Phone:305-664-2488
Practice Address - Fax:305-664-2489
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35228OtherBCBS INDIVIDUAL NUMBER
FLH10706Medicare UPIN
FLE3669Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER