Healthcare Provider Details

I. General information

NPI: 1023327707
Provider Name (Legal Business Name): RICHARD I. GOLDBERGER, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5106 N ARMENIA AVE STE 4
TAMPA FL
33603-1433
US

IV. Provider business mailing address

5106 N ARMENIA AVE STE 4
TAMPA FL
33603-1433
US

V. Phone/Fax

Practice location:
  • Phone: 813-875-0074
  • Fax: 813-878-0186
Mailing address:
  • Phone: 813-875-0074
  • Fax: 813-878-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD GOLDBERGER
Title or Position: OWNER
Credential: M.D.
Phone: 813-875-0074