MEDICARE: DR. LOUIS DAVID 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	2084P0800X	Psychiatry Physician	ME70557	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

General Provider Information

NPI Number	:	1730160292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS DAVID GOLD M.D.

Provider Business Mailing Address
First Line	:	9080 KIMBERLY BLVD
Second Line	:	SUITE 5
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2862
Country	:	US
Telephone Number	:	561-477-7150
Fax Number	:	561-477-7161

Provider Business Practice Location Address
First Line	:	9080 KIMBERLY BLVD
Second Line	:	SUITE 5
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2862
Country	:	US
Telephone Number	:	561-477-7150
Fax Number	:	561-477-7161

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/09/2007

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