Active NPI
Miranda R Goen, PT, DPT, OCS
- Physical Therapist
- Tampa, FL
National Provider Identifier
1417575291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305213562
- Practice address
- 16037 Tampa Palms Blvd W Ste C
Tampa, FL 33647-2001 - Phone
- (813) 542-8188
- NPI assigned
- Jul 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 38102 | FL | |
| Physical Therapist | 225100000X | 2305213562 | VA | Primary |
Addresses
Primary practice location
16037 Tampa Palms Blvd W Ste C
Tampa, FL 33647-2001
Mailing address
16037 Tampa Palms Blvd W Ste C
Tampa, FL 33647-2001
Phone (813) 542-8188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38102 | FL | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1417575291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16037 TAMPA PALMS BLVD W STE C",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472001",
"telephone_number": "813-542-8188",
"fax_number": "813-542-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16037 TAMPA PALMS BLVD W STE C",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472001",
"telephone_number": "813-542-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEN",
"first_name": "MIRANDA",
"middle_name": "R",
"credential": "PT, DPT, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "FL",
"license": "38102",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305213562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.