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General NPI Number Information
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NPI Number | 1932350659
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Entity Type | Organization
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Legal Business Name | SCOTT GOLDBERG DC PA
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 14201 W SUNRISE BLVD SUITE 202
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City | SUNRISE
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State | FL
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Zip | 33323-3207
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Country | US
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Telephone | 954-397-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 14440 GREENBRIER PL
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City | DAVIE
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State | FL
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Zip | 33325-6339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT GOLDBERG
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Credential | D.C
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Telephone | 954-336-7338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7414
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License Number State | FL
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