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Mr. Stephen Randall Goodman, MASSAGETHERAPIST
Specialist in Venice, Florida
NPI 1750518007

Stephen Randall Goodman is a Specialist based in Venice, FL. Stephen Randall Goodman practices in Venice, FL and has the professional credentials of MASSAGETHERAPIST. The NPI Number for Stephen Randall Goodman is 1750518007 and holds a License No. MA55323 (Florida).

The current practice location address for Stephen Randall Goodman is 328 Tamiami Trl S Ste A, Venice, FL and can be reached out via phone at 941-485-5797.

Location: 328 Tamiami Trl S Ste A, Venice, FL, 34292-4661
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750518007
Provider Name
Stephen Randall Goodman
Credential
MASSAGETHERAPIST
Provider Entity Type
Individual
Gender
Male
Address
328 Tamiami Trl S Ste A, Venice, FL, 34292-4661
Phone Number
941-485-5797
Fax Number
Provider Enumeration Date
06/14/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MA55323 01 FL BLUE CROSS BLUE SHIELD OF FLORIDA
institution
Provider Business Practice Location Address Details
Address
328 Tamiami Trl S Ste A
City
Venice
State
Florida
Zip
34285-2434
Phone Number
941-485-5797
Fax Number
person
Provider Business Mailing Address Details
Address
328 Tamiami Trl S Ste A
City
Venice
State
Florida
Zip
34285-2434
Phone Number
941-485-5797
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MA55323 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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