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General NPI Number Information
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NPI Number | 1831250240
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Entity Type | Organization
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Legal Business Name | PAUL N GOTKIN & DAVID A GUBERNICK DPM PA
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 1090 VIRGINIA AVE
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City | FORT PIERCE
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State | FL
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Zip | 34982-3640
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Country | US
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Telephone | 772-461-2575
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Fax | 772-461-0419
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Provider Business Mailing Address
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Address Line | 2291 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-4530
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Country | US
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Telephone | 772-286-9912
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Fax | 772-286-2405
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL N GOTKIN
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Credential | DPM
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Telephone | 772-286-9912
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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 |
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License Number State |
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