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General NPI Number Information
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NPI Number | 1568468445
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Entity Type | Individual
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Provider Name | MITCHELL E GOLDSTEIN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 9970 CENTRAL PARK BLVD N STE 400
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City | BOCA RATON
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State | FL
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Zip | 33428-2236
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Country | US
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Telephone | 561-487-7931
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Fax | 561-487-1204
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Provider Business Mailing Address
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Address Line | ASSOCIATED FAMILY PHYSICIANS OF BOCA RATON, P.L. 9910 SANDALFOOT BLVD., SUITE 1
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City | BOCA RATON
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State | FL
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Zip | 33428-6692
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Country | US
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Telephone | 561-883-3030
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Fax | 561-852-7611
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0004093
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License Number State | FL
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