Healthcare Provider Details

I. General information

NPI: 1881828127
Provider Name (Legal Business Name): TROY JOSEPH GOLDENBERG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SE JOHNSON AVE STE LH
STUART FL
34994-3816
US

IV. Provider business mailing address

2404 NE PALM AVE
JENSEN BEACH FL
34957-5246
US

V. Phone/Fax

Practice location:
  • Phone: 772-453-1072
  • Fax: 772-510-4229
Mailing address:
  • Phone: 772-453-1072
  • Fax: 772-453-1072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4520
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License NumberAP4520
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: