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General NPI Number Information
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NPI Number | 1114106366
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Entity Type | Organization
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Legal Business Name | ADINA S. GOULD OD PA
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 4308 ALTON RD STE 910
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4560
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Country | US
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Telephone | 786-586-9404
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Fax |
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Provider Business Mailing Address
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Address Line | 6535 ALLISON RD.
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City | MIAMI BEACH
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State | FLORIDA
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Zip | 33141
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Country | UM
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Telephone | 786-586-9404
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Fax | 305-695-0662
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADINA S GOULD
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Credential | OD
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Telephone | 786-586-9404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3743
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License Number State | FL
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