Provider Demographics
NPI:1447245212
Name:GOLDSAND, CARL STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:STEVEN
Last Name:GOLDSAND
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 1:16501 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6005
Mailing Address - Country:US
Mailing Address - Phone:305-354-4558
Mailing Address - Fax:305-354-3884
Practice Address - Street 1:16501 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6005
Practice Address - Country:US
Practice Address - Phone:305-354-4558
Practice Address - Fax:305-354-3884
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2022-11-21
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
FLME26504174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045922400Medicaid
FL650426336Medicare PIN
FL96605Medicare ID - Type UnspecifiedMEDICAR PROVIDER NUMBER
FLD45436Medicare UPIN