Healthcare Provider Details

I. General information

NPI: 1467427633
Provider Name (Legal Business Name): STEVE ERIC GOLDWASSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 5010
ST AUGUSTINE FL
32086-3705
US

IV. Provider business mailing address

309 PLAZA
ATLANTIC BEACH FL
32233-5441
US

V. Phone/Fax

Practice location:
  • Phone: 904-533-6686
  • Fax: 904-533-6787
Mailing address:
  • Phone: 904-535-4104
  • Fax: 904-533-6787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME80864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: