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General NPI Number Information
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NPI Number | 1144469990
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Entity Type | Organization
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Legal Business Name | RICHARD M GOLDBERG MD PA
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 1250 S TAMIAMI TRL SUITE 103
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City | SARASOTA
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State | FL
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Zip | 34239-2221
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Country | US
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Telephone | 941-951-2100
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Fax | 941-894-3123
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Provider Business Mailing Address
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Address Line | 1250 S TAMIAMI TRL SUITE 103
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City | SARASOTA
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State | FL
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Zip | 34239-2221
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Country | US
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Telephone | 941-951-2100
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Fax | 941-894-3123
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RICHARD GOLDBERG
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Credential | M.D.
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Telephone | 941-951-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME50004
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License Number State | FL
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