MEDICARE: NORMAN M GOLDGLANTZ OD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC001276	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649336983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORMAN M GOLDGLANTZ OD PA

Provider Business Mailing Address
First Line	:	14030 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3443
Country	:	US
Telephone Number	:	305-981-4775
Fax Number	:

Provider Business Practice Location Address
First Line	:	14030 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3443
Country	:	US
Telephone Number	:	305-981-4775
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER OPTOMETRIST
Name	:	DR. NORMAN M GOLDGLANTZ
Credential	:	OD
Telephone Number	:	305-981-4775

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	08/22/2020

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