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Organization

DAYTONA FOOT & ANKLE SPECIALISTS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ERIC MARK GOLDENBERG D.P.M. (PRESIDENT)
(386) 252-9656
Entity
Organization

Contact information

Practice address
311 N CLYDE MORRIS BLVD, SUITE 300, DAYTONA BEACH, FL 32114-2756
(386) 252-9656
(386) 252-4649
Mailing address
311 N CLYDE MORRIS BLVD, SUITE 300, DAYTONA BEACH, FL 32114-2756
(386) 252-9656
(386) 252-4649

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2530
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340118900
FL
01
65673
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/08/2007
Last updated
09/24/2010
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