Goodhart, Glenn Lee
Goodhart, Glenn Lee is an sole proprietor health care provider with primary practice located at 40100 Highway 27 , Davenport FL 33837-5906. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Goodhart, Glenn Lee can be contacted via phone (863) 422-4971.Contact Information
Primary practice address
40100 Highway 27
Davenport FL 33837-5906
Phone: (863) 422-4971
Fax: (863) 419-2264
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD-43462 | Iowa |
| Other Service Providers / Specialist | 174400000X | D29594 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME116577 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 19386 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD034685L | Pennsylvania |
Profile Details
| NPI number | 1568481356 |
|---|---|
| LBN Legal business name | Goodhart, Glenn Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568481356 | NPPES |
| Georgia | MEDICAID | 00213694A | |
| Georgia | Other | 019386 | |
| Georgia | Other | 85001797G | |
| Georgia | Other | 854101 | |
| Georgia | Other | 2027755 | |
| Georgia | Other | 9206456 | |
| Georgia | Other | 52241370 | |
| Georgia | Other | 52241370 |
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