MEDICARE: MS. PAMELA SUSAN GOLDSMITH M.A.

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	101YP2500X	Professional Counselor	MH7419	FL

General Provider Information

NPI Number	:	1447429659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA SUSAN GOLDSMITH M.A.

Provider Business Mailing Address
First Line	:	650 MAITLAND AVE
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-6862
Country	:	US
Telephone Number	:	407-975-0400
Fax Number	:	407-696-4831

Provider Business Practice Location Address
First Line	:	650 MAITLAND AVE
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-6862
Country	:	US
Telephone Number	:	407-975-0400
Fax Number	:	407-696-4831

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

Provider Enumeration Date	:	02/22/2008
Last Update Date	:	11/30/2016

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