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General NPI Number Information
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NPI Number | 1639235765
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Entity Type | Individual
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Provider Name | KEITH GOLDSTEIN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 4649 GARDENS PARK BLVD APT 3308
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City | ORLANDO
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State | FL
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Zip | 32839-2623
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Country | US
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Telephone | 407-509-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 4649 GARDENS PARK BLVD APT 3308
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City | ORLANDO
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State | FL
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Zip | 32839-2623
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Country | US
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Telephone | 407-509-8852
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2436
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License Number State | FL
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