Healthcare Provider Details

I. General information

NPI: 1255334413
Provider Name (Legal Business Name): HERBERT GOLDBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

500 N HIATUS RD STE 200
PEMBROKE PINES FL
33026-5213
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-2000
  • Fax: 954-437-6628
Mailing address:
  • Phone: 954-437-4800
  • Fax: 954-437-6628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberME37011
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: