Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 9107921 | FL |
NPI | 1174862155 |
---|---|
Provider Name | Brian D Goldmark |
First Address | Atlanta, GA 30384-0905 |
Second Address | Miami, FL 33176-2144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2013 |
Last Update Date | 16/04/2021 |