Provider Demographics
NPI:1407878812
Name:GOLDMAN, HOWARD B (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:B
Last Name:GOLDMAN
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 1:950 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2310
Mailing Address - Country:US
Mailing Address - Phone:561-391-8300
Mailing Address - Fax:561-391-3744
Practice Address - Street 1:950 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2310
Practice Address - Country:US
Practice Address - Phone:561-391-8300
Practice Address - Fax:561-391-3744
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30272174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31094Medicare ID - Type Unspecified
FLD54210Medicare UPIN