Provider Demographics
NPI:1306035035
Name:HOWARD GOLDMAN MD PA
Entity Type:Organization
Organization Name:HOWARD GOLDMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-753-5365
Mailing Address - Street 1:5550 26TH ST W
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-3514
Mailing Address - Country:US
Mailing Address - Phone:941-753-5365
Mailing Address - Fax:
Practice Address - Street 1:5550 26TH ST W
Practice Address - Street 2:SUITE 4
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-3514
Practice Address - Country:US
Practice Address - Phone:941-753-5365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1032Medicare PIN