Provider Demographics
NPI:1376969873
Name:GOLDSTEIN, SARA (MS, CGC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 CENTRAL AVE STE 1230
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3865
Mailing Address - Country:US
Mailing Address - Phone:800-975-4819
Mailing Address - Fax:760-203-1194
Practice Address - Street 1:360 CENTRAL AVE STE 1230
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3865
Practice Address - Country:US
Practice Address - Phone:800-975-4819
Practice Address - Fax:760-203-1194
Is Sole Proprietor?:No
Enumeration Date:2014-03-09
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS