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General NPI Number Information
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NPI Number | 1235454638
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Entity Type | Individual
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Provider Name | RAUL GUSTAVO GOSTHE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 9380 SW 150TH ST SUITE 270
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City | MIAMI
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State | FL
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Zip | 33176-7947
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Country | US
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Telephone | 305-256-4334
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Fax | 305-256-4336
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Provider Business Mailing Address
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Address Line | 9380 SW 150TH ST SUITE 270
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City | MIAMI
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State | FL
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Zip | 33176-7947
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Country | US
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Telephone | 305-256-4334
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Fax | 305-256-4336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | ME124404
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License Number State | FL
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