Individual
DR. BERNARD GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13615 BRUCE B DOWNS BLVD, SUITE 112, TAMPA, FL 33613-4607
(813) 972-3338
(813) 977-9070
Mailing address
13615 BRUCE B DOWNS BLVD, SUITE 112, TAMPA, FL 33613-4607
(813) 972-3338
(813) 977-9070
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO0000369
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029739900
—
FL
01
—
0867240001
PTAN/DME#
FL
01
—
480014804
RAILROAD MEDICARE
FL
01
—
591305394
TAX ID
FL
01
—
CG3347
RAILROAD MEDICARE
FL
Enumeration date
10/12/2006
Last updated
02/09/2011
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