Provider Demographics
NPI:1356321400
Name:GOODIER, MELODEE ANNE (AMT)
Entity Type:Individual
Prefix:MS
First Name:MELODEE
Middle Name:ANNE
Last Name:GOODIER
Suffix:
Gender:F
Credentials:AMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 MORTON PLANT STREET
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756
Mailing Address - Country:US
Mailing Address - Phone:727-461-8635
Mailing Address - Fax:727-461-8648
Practice Address - Street 1:15100 RESCUE WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762
Practice Address - Country:US
Practice Address - Phone:727-535-1437
Practice Address - Fax:727-535-4190
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160234-16174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL160234OtherAMERICAN MEDICAL TECHNOLO