Healthcare Provider Details

I. General information

NPI: 1003067786
Provider Name (Legal Business Name): STEFANIE SAMANTHA GOLD MAYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 N FEDERAL HWY
BOCA RATON FL
33431-5133
US

IV. Provider business mailing address

4700 EXCHANGE COURT SUITE 110
BOCA RATON FL
33431-4450
US

V. Phone/Fax

Practice location:
  • Phone: 561-362-8000
  • Fax: 561-437-6806
Mailing address:
  • Phone: 561-362-8000
  • Fax: 561-477-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9104609
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: