Healthcare Provider Details
I. General information
NPI: 1245919240
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: 07/17/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13590 S JOG RD STE 7
DELRAY BEACH FL
33446-3807
US
IV. Provider business mailing address
9970 CENTRAL PARK BLVD N STE 300
BOCA RATON FL
33428-2237
US
V. Phone/Fax
- Phone: 561-637-4200
- Fax:
- Phone: 561-488-2200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARC
DAVID
GOLDEN
Title or Position: OWNER
Credential: DO
Phone: 561-637-4200