Individual
LAWRENCE GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6950 CENTRAL AVE, ST PETERSBURG, FL 33707-1210
(727) 343-3004
(727) 343-9521
Mailing address
6250 KIPPS COLONY CT APT 304, GULFPORT, FL 33707-3983
(727) 343-3004
(727) 343-9521
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0035408
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066311500
—
FL
Enumeration date
07/28/2006
Last updated
09/26/2022
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