Provider Demographics
NPI:1235226598
Name:GOLDBERG, MURRAY GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:GLENN
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 5300
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3415
Mailing Address - Country:US
Mailing Address - Phone:561-833-5594
Mailing Address - Fax:561-833-0017
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 5300
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3415
Practice Address - Country:US
Practice Address - Phone:561-833-5594
Practice Address - Fax:561-833-0017
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0059564208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6732100002OtherMEDICARE DME
FL12163ZMedicare PIN
FL6732100002OtherMEDICARE DME
FL12163YMedicare PIN