Provider Demographics
NPI:1831579457
Name:GOODWIN, AARON M (DO, DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:GOODWIN
Suffix:
Gender:M
Credentials:DO, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5824 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:731 STIRLING CENTER PL UNIT 1951
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5210
Practice Address - Country:US
Practice Address - Phone:407-333-1335
Practice Address - Fax:407-333-1244
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21664122300000X
FLOS15033208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No122300000XDental ProvidersDentist