Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY5723 | FL |
Y | 103TC0700X | Clinical Psychologist | PY5723 | FL |
N | 103G00000X | Clinical Psychologist | PY5723 | FL |
N | 103TC0700X | Clinical Psychologist | PY5723 | FL |
N | 103TH0100X | Health Service | PY5723 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY5723 | FL |
NPI | 1255476792 |
---|---|
Provider Name | Dr. Stuart George Gold |
First Address | Miami, FL 33136-1409 |
Second Address | Miami, FL 33136-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 01/02/2008 |