Provider Demographics
NPI:1023356490
Name:GOODMAN, HOWELL STEWART JR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:HOWELL
Middle Name:STEWART
Last Name:GOODMAN
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 CAPITAL CIR NE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4303
Mailing Address - Country:US
Mailing Address - Phone:850-297-0430
Mailing Address - Fax:
Practice Address - Street 1:2111 CAPITAL CIR NE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4303
Practice Address - Country:US
Practice Address - Phone:850-297-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46851183500000X
GARPH026339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist