R Thad Goodwin MD PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0037950 Issued in FL

Legal business name

R THAD GOODWIN MD PA

Practice address

1510 Royal Palm Square Blvd
Ste 106
Fort Myers, FL 33919-1068

Phone

(239) 939-3937

Fax

(239) 275-8045

NPI assigned

Oct 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robin Thad Goodwin, M.D.

Title

President

Phone

(239) 939-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Marc Mandelkorn, M.D.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1457455990
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1285813410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-939-3937",
            "fax_number": "239-275-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-939-3937",
            "fax_number": "239-275-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R THAD GOODWIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "THAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-939-3937",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0037950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042931700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susana Quintero, M.S.
• Miranda Quinton, FNP-C
• Grecia Quiroz Garcia
• Amir Qureshi, MD
• R Paul Liccini MD LLC
• R.C.F Home Health Care Agency, LLC
• Eric Raab, D.O.
• Robert Raab, M-CAP
• Stephen Leo Raben, M.D.
• Marc Anthony Rabideau, D.M.D.

• Ophthalmology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.