Individual
DR. JACK DEEMS GOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
15151 S US HIGHWAY 441 STE 300, SUMMERFIELD, FL 34491-4482
(352) 502-3525
(352) 732-7333
Mailing address
15151 S US HIGHWAY 441 STE 300, SUMMERFIELD, FL 34491-4482
(352) 502-3525
(352) 732-7333
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08KTA
BC/BS
FL
01
—
90100
BC/BS
FL
Enumeration date
05/17/2006
Last updated
07/21/2022
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