# LIFEWELL MEDICAL PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134066756
- **Authorized official:** YITZCHAK GOLDSMITH DO (PRESIDENT)
- **Authorized official phone:** (845) 360-2552

## Contact information

- **Practice address:** 220 9TH ST, PORT SAINT JOE, FL 32456-1924
- **Practice address phone:** (845) 360-2552
- **Mailing address:** 23 ROBERT PITT DR STE 102A, MONSEY, NY 10952-3470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2026
- **Last updated:** 05/01/2026