Healthcare Provider Details

I. General information

NPI: 1447245212
Provider Name (Legal Business Name): CARL STEVEN GOLDSAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date: 03/23/2006
Reactivation Date: 03/31/2006

III. Provider practice location address

16501 NW 2ND AVE
MIAMI FL
33169-6005
US

IV. Provider business mailing address

16501 NW 2ND AVE
MIAMI FL
33169-6005
US

V. Phone/Fax

Practice location:
  • Phone: 305-354-4558
  • Fax: 305-354-3884
Mailing address:
  • Phone: 305-354-4558
  • Fax: 305-354-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME26504
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME26504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: