Individual
PAUL B GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1070 N STONE ST, SUITE D, DELAND, FL 32720-0919
(386) 822-9410
(386) 469-0045
Mailing address
1070 N STONE ST, SUITE D, DELAND, FL 32720-0919
(386) 822-9410
(386) 469-0045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME36213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269725400
—
FL
01
—
593256803
FEI #
—
Enumeration date
05/08/2006
Last updated
03/10/2011
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