Provider Demographics
NPI:1497939433
Name:GOODMAN, LAWRENCE EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:EDWARD
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 SEGOVIA STREET
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6500
Mailing Address - Country:US
Mailing Address - Phone:305-206-0151
Mailing Address - Fax:
Practice Address - Street 1:8603 S DIXIE HWY
Practice Address - Street 2:SUITE # 411
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7807
Practice Address - Country:US
Practice Address - Phone:305-595-4681
Practice Address - Fax:305-273-9584
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor