Organization
FORT LAUDERDALE MEDICAL SURGICAL ASSOCIATES., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY GOSHEN DO (OWNER)
(954) 567-5898
Entity
Organization
Contact information
Practice address
2301 WILTON DR, SUITE C2, WILTON MANORS, FL 33305-1202
(954) 567-5898
(954) 567-0395
Mailing address
2301 WILTON DR, SUITE C2, WILTON MANORS, FL 33305-1202
(954) 567-5898
(954) 567-0395
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
OS8504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266516600
—
FL
01
—
57739
MEDICARE
—
Enumeration date
11/06/2012
Last updated
12/07/2012
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