MEDICARE: MR. ERNEST DENNIS GOLIN ATC,LMT,CSTS

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	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	AL44	FL

General Provider Information

NPI Number	:	1982698015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERNEST DENNIS GOLIN ATC,LMT,CSTS

Provider Business Mailing Address
First Line	:	5336 ARCHSTONE DR
Second Line	:	UNIT 207
City	:	TAMPA
State	:	FL
Zip	:	33634-4235
Country	:	US
Telephone Number	:	813-887-1909
Fax Number	:	813-887-1909

Provider Business Practice Location Address
First Line	:	5336 ARCHSTONE DR
Second Line	:	UNIT 207
City	:	TAMPA
State	:	FL
Zip	:	33634-4235
Country	:	US
Telephone Number	:	813-887-1909
Fax Number	:	813-887-1909

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

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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