Organization
LAWRENCE R. GOLDBERG M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE GOLDBERG M.D. (OWNER)
(727) 521-4669
Entity
Organization
Contact information
Practice address
4957 38TH AVE N, SUITE D, SAINT PETERSBURG, FL 33710-2174
(727) 521-4669
Mailing address
4957 38TH AVE N, SUITE D, SAINT PETERSBURG, FL 33710-2174
(727) 521-4669
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0035408
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066311500
—
FL
Enumeration date
10/21/2010
Last updated
10/21/2010
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