Individual
DR. KEITH STUART GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4107 N HIMES AVE STE 101A, TAMPA, FL 33607-6645
(813) 374-0325
(844) 643-4379
Mailing address
4822 TEA ROSE CT, LUTZ, FL 33558-9005
(724) 396-3841
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MD-037485-E
PA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
ME-89764
FL
207Q00000X
Family Medicine Physician
MD-037485-E
PA
207Q00000X
Family Medicine Physician
ME-89764
FL
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
ME-89764
FL
2083X0100X
Occupational Medicine Physician
Primary
MD-037485-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0422993
BS/BC PROVIDER ID#
PA
Enumeration date
03/29/2006
Last updated
04/07/2020
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