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Individual

IRA E. GOLDSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5900 STATE ROAD 7, LAKE WORTH, FL 33449-5404
(561) 967-4548
(561) 967-4572
Mailing address
5900 STATE ROAD 7, LAKE WORTH, FL 33467-5404
(561) 967-4548
(561) 967-4572

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC 1277
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0848107 00
FL
Enumeration date
10/29/2008
Last updated
10/29/2008
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