Provider Demographics
NPI:1235344326
Name:GOLISH, STANLEY RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:RAYMOND
Last Name:GOLISH
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 1:2055 MILITARY TRL STE 303
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7830
Mailing Address - Country:US
Mailing Address - Phone:561-427-0860
Mailing Address - Fax:561-427-0870
Practice Address - Street 1:2055 MILITARY TRL STE 303
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7830
Practice Address - Country:US
Practice Address - Phone:561-427-0860
Practice Address - Fax:561-427-0870
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 109348207XS0117X
FLME104974207XS0117X
WAMD60183304207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine