Provider Demographics
NPI:1134910615
Name:GOODWIN, EMMA (OD, MS)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9068
Mailing Address - Country:US
Mailing Address - Phone:919-349-2659
Mailing Address - Fax:
Practice Address - Street 1:900 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1134
Practice Address - Country:US
Practice Address - Phone:305-243-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program