Provider Demographics
NPI:1447202049
Name:GOLDBERG, STEVEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:GOLDBERG
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 1:6376 PINE RIDGE RD STE 430
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3905
Mailing Address - Country:US
Mailing Address - Phone:239-316-7600
Mailing Address - Fax:239-316-7509
Practice Address - Street 1:6376 PINE RIDGE RD STE 430
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3905
Practice Address - Country:US
Practice Address - Phone:239-316-7600
Practice Address - Fax:239-316-7509
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLME0093442207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00698982OtherMEDICARE RAILROAD
FL28618OtherBCBS
FL272987300Medicaid
FL272987300Medicaid
FL28618VMedicare PIN