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General NPI Number Information
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NPI Number | 1386292282
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Entity Type | Organization
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Legal Business Name | GOLD STANDARD THERAPEUTICS, LLC
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 2280 SW 70TH AVE STE 6
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City | DAVIE
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State | FL
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Zip | 33317-7132
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Country | US
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Telephone | 614-374-5394
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Fax |
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Provider Business Mailing Address
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Address Line | 725 NW 99TH CIR
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City | PLANTATION
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State | FL
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Zip | 33324-4946
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Country | US
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Telephone | 614-374-5394
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. JAIME GOLD
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Credential | DPT
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Telephone | 614-374-5394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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