Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | OS008597 | FL |
NPI | 1437148368 |
---|---|
Provider Name | Dr. Dean Robert Goldberg |
First Address | Clearwater, FL 33757-8744 |
Second Address | Tampa, FL 33607-6546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 16/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
265561600 | (05) | FL |