Provider Demographics
NPI:1225093149
Name:GOLIO, DOMINICK IMUNDI (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:IMUNDI
Last Name:GOLIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10088 INDIANTOWN RD STE B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-4738
Mailing Address - Country:US
Mailing Address - Phone:561-292-5300
Mailing Address - Fax:646-350-0512
Practice Address - Street 1:10088 INDIANTOWN RD STE B
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-4738
Practice Address - Country:US
Practice Address - Phone:561-250-0655
Practice Address - Fax:646-350-0512
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY236097207W00000X, 208200000X
FLME00870532086S0122X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH94351Medicare UPIN