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General NPI Number Information
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NPI Number | 1023480985
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Entity Type | Organization
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Legal Business Name | FIDEL S. GOLDSON, DC PA
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 734 N STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-2129
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Country | US
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Telephone | 954-584-3774
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Fax | 954-583-0497
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Provider Business Mailing Address
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Address Line | 734 N STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-2129
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Country | US
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Telephone | 954-584-3774
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Fax | 954-583-0497
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FIDEL GOLDSON
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Credential | DC, PT
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Telephone | 954-584-3774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT19489
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | CH9276
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License Number State | FL
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