Provider Demographics
NPI:1669713483
Name:GOODHUE, BRIAN (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:GOODHUE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3093 TERRAMAR DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7702
Mailing Address - Country:US
Mailing Address - Phone:978-869-8843
Mailing Address - Fax:614-340-3516
Practice Address - Street 1:160 NW 170TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5521
Practice Address - Country:US
Practice Address - Phone:305-651-1100
Practice Address - Fax:305-654-5274
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16414207P00000X, 207PE0004X
OH34.011925207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine