Healthcare Provider Details

I. General information

NPI: 1366065328
Provider Name (Legal Business Name): GOLDEN ORTHOPEDIC KNEE HIP SHOULDER AND FOOT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9970 CENTRAL PARK BLVD N STE 300
BOCA RATON FL
33428-2237
US

IV. Provider business mailing address

9970 CENTRAL PARK BLVD N STE 300
BOCA RATON FL
33428-2237
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-2200
  • Fax: 561-488-1064
Mailing address:
  • Phone: 561-488-2200
  • Fax: 561-488-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MARC GOLDEN
Title or Position: AUTHORIZED OFFICIAL
Credential: DO
Phone: 561-488-2200