MEDICARE: DR. HOWARD S GOLD M.D.

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	207L00000X	Anesthesiology Physician	ME50003	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04986	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1265417638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD S GOLD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 840207
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33084-2207
Country	:	US
Telephone Number	:	305-595-4510
Fax Number	:

Provider Business Practice Location Address
First Line	:	9370 SUNSET DR
Second Line	:	SUITE A-250
City	:	MIAMI
State	:	FL
Zip	:	33173-5431
Country	:	US
Telephone Number	:	305-595-4510
Fax Number	:

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	07/08/2007

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