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NPI Code Detail

MEDICARE: HERBERT GOLDWIRE PA

MEDICARE: HERBERT GOLDWIRE PA
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
1363LP2300XPrimary Care Nurse PractitionerARNP9207809FL

General Provider Information

NPI Number : 1578823886
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERBERT GOLDWIRE PA
Provider Business Mailing Address
First Line : 20 NW 13TH AVE
Second Line :
City : DANIA
State : FL
Zip : 33004-5107
Country : US
Telephone Number : 954-681-2881
Fax Number :
Provider Business Practice Location Address
First Line : 3075 NW 35TH AVE
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33311-1107
Country : US
Telephone Number : 954-681-2881
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. HERBERT GOLDWIRE
Credential : ARNP
Telephone Number : 954-681-2881
Provider Enumeration Date : 05/21/2012
Last Update Date : 05/21/2012

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Directions to “HERBERT GOLDWIRE PA ” Practice Location

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