Healthcare Provider Details

I. General information

NPI: 1780914960
Provider Name (Legal Business Name): STEVEN S. GOLDBERG, MD PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6376 PINE RIDGE RD # 430
NAPLES FL
34119-3905
US

IV. Provider business mailing address

6376 PINE RIDGE RD STE 430
NAPLES FL
34119-3905
US

V. Phone/Fax

Practice location:
  • Phone: 239-316-7600
  • Fax: 239-316-7600
Mailing address:
  • Phone: 239-316-7600
  • Fax: 239-316-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6377460001
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN S GOLDBERG
Title or Position: OWNER
Credential: MD
Phone: 239-348-4400