Provider Demographics
NPI:1821393299
Name:G. GOODWIN & ASSOCIATES, INC
Entity Type:Organization
Organization Name:G. GOODWIN & ASSOCIATES, INC
Other - Org Name:GOODWIN & SMITH, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-643-9648
Mailing Address - Street 1:PO BOX 7388
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-7388
Mailing Address - Country:US
Mailing Address - Phone:727-643-9648
Mailing Address - Fax:
Practice Address - Street 1:600 BYPASS DR
Practice Address - Street 2:SUITE 108
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5078
Practice Address - Country:US
Practice Address - Phone:727-643-9648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management