Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D50663 | FL |
Y | 208600000X | Surgeon | D50663 | FL |
N | 2086X0206X | Surgical Oncologist | D50663 | FL |
NPI | 1114962248 |
---|---|
Provider Name | Dr. Steven Bradley Goldin |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Port Charlotte, FL 33948-1025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
261943100 | (05) | MD |
7685148 | AETNA (01) | FL |
998104 | WELLCARE (01) | FL |
P01342438 | RR MEDICARE (01) | FL |
P01343444 | RR MEDICARE (01) | FL |
P04478 | FREEDOM (01) | FL |
P203601 | OPTIMUM (01) | FL |