Provider Demographics
NPI:1285845529
Name:GOLD, PATRICIA DAWSON (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:DAWSON
Last Name:GOLD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:840 WAKULLA LN
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3831
Mailing Address - Country:US
Mailing Address - Phone:407-539-4856
Mailing Address - Fax:407-855-5281
Practice Address - Street 1:5687 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4969
Practice Address - Country:US
Practice Address - Phone:321-926-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4013152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU86954Medicare UPIN