MEDICARE: SUZANNE GOLD LCSW

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
1	1041C0700X	Clinical Social Worker	SW4264	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063614816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE GOLD LCSW

Provider Business Mailing Address
First Line	:	9990 SW 77TH AVE STE 217
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2618
Country	:	US
Telephone Number	:	305-323-1994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 S DIXIE HWY
Second Line	:	SUITE 1140
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2926
Country	:	US
Telephone Number	:	305-668-9000
Fax Number	:	305-662-1788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	11/13/2024

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