Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME80864 | FL |
NPI | 1467427633 |
---|---|
Provider Name | Steve Eric Goldwasser |
First Address | Jacksonville, FL 32245-6568 |
Second Address | Jacksonville, FL 32258-5468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 14/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000876356A | (05) | GA |
259352100 | (05) | FL |
G44241 | (02) | FL |