Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME0090561 | FL |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME90561 | FL |
NPI | 1629064670 |
---|---|
Provider Name | Mr. Joshua Goldman |
First Address | Tampa, FL 33622-5317 |
Second Address | Safety Harbor, FL 34695-6602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 09/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270827200 | (05) | FL |
I24252 | (02) | FL |