Provider Demographics
NPI:1518221266
Name:GOLDSMIT, SAMUEL KALB (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:KALB
Last Name:GOLDSMIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMUEL
Other - Middle Name:KALB
Other - Last Name:GOLDSMIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:788 NE 23RD ST UNIT 2602
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5910
Mailing Address - Country:US
Mailing Address - Phone:619-823-7475
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON RD STE 830
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33140-2899
Practice Address - Country:US
Practice Address - Phone:305-674-2950
Practice Address - Fax:305-674-2749
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73464207T00000X
FL140441207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR73464OtherTRAINING PERMIT