Provider Demographics
NPI:1376608554
Name:GULF CENTRAL EARLY STEPS
Entity Type:Organization
Organization Name:GULF CENTRAL EARLY STEPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-487-5402
Mailing Address - Street 1:3223 OLD OAK DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5020
Mailing Address - Country:US
Mailing Address - Phone:941-953-5700
Mailing Address - Fax:941-955-6169
Practice Address - Street 1:3223 OLD OAK DR
Practice Address - Street 2:SARASOTA
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5020
Practice Address - Country:US
Practice Address - Phone:941-953-5700
Practice Address - Fax:941-955-6269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0003644251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036130500Medicaid
FL036130500Medicaid