=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881828127
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TROY JOSEPH GOLDENBERG L.AC.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2009
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 SE JOHNSON AVE STE LH
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34994-3816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-453-1072
-----------------------------------------------------
Fax | 772-510-4229
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2404 NE PALM AVE
-----------------------------------------------------
City | JENSEN BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34957-5246
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-453-1072
-----------------------------------------------------
Fax | 772-453-1072
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP4520
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 224Y00000X
-----------------------------------------------------
Taxonomy Name | Clinical Exercise Physiologist
-----------------------------------------------------
License Number | AP4520
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC12823
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------