Provider Demographics
NPI:1093753824
Name:GOLD, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1033 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1547
Mailing Address - Country:US
Mailing Address - Phone:727-456-4250
Mailing Address - Fax:727-346-1044
Practice Address - Street 1:790 CONCOURSE PKWY S
Practice Address - Street 2:SUITE 200
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-767-6411
Practice Address - Fax:407-767-8160
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME50719207W00000X
FL50719207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046321300Medicaid
FL180010279Medicare PIN
FL046321300Medicaid
FL1125953Medicare PIN
FL03798YMedicare PIN
FL03798ZMedicare PIN
FL1125658Medicare PIN