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NPI Code Detail

MEDICARE: MARK GOLDSTEIN MD

MEDICARE: MARK GOLDSTEIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianME41855FL

General Provider Information

NPI Number : 1013952282
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK GOLDSTEIN MD
Provider Business Mailing Address
First Line : 5700 LAKE WORTH RD
Second Line : #204
City : GREENACRES
State : FL
Zip : 33463-4727
Country : US
Telephone Number : 561-968-7968
Fax Number : 561-964-4603
Provider Business Practice Location Address
First Line : 140 JFK DR
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-6608
Country : US
Telephone Number : 561-968-6767
Fax Number : 561-641-0814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 10/03/2007

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Directions to “ MARK GOLDSTEIN MD” Practice Location

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