Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME74763 | FL |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME74763 | FL |
N | 207ND0900X | Dermatopathologist | ME74763 | FL |
NPI | 1619900388 |
---|---|
Provider Name | Cynthia Golomb |
First Address | Hallandale Beach, FL 33009-4373 |
Second Address | Hallandale Beach, FL 33009-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E5238X | (02) | FL |
G74292 | (02) | FL |