Provider Demographics
NPI:1164691747
Name:GOLESORKHI, NEGAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NEGAR
Middle Name:
Last Name:GOLESORKHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PINELLAS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3312
Mailing Address - Country:US
Mailing Address - Phone:727-462-2131
Mailing Address - Fax:941-472-7266
Practice Address - Street 1:400 PINELLAS ST STE 200
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-462-2131
Practice Address - Fax:941-472-7266
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD85765208600000X, 2086X0206X
FLME1476172086X0206X, 208600000X
VA01012458302086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101245830OtherMEDICAL LISENCE