Provider Demographics
NPI:1639166820
Name:GOLD, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:GOLD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10151 ENTERPRISE CENTER BLVD
Mailing Address - Street 2:SUITE201
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3759
Mailing Address - Country:US
Mailing Address - Phone:561-737-9191
Mailing Address - Fax:561-733-9145
Practice Address - Street 1:10151 ENTERPRISE CENTER BLVD
Practice Address - Street 2:SUITE201
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3759
Practice Address - Country:US
Practice Address - Phone:561-737-9191
Practice Address - Fax:561-733-9145
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2023-12-05
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Provider Licenses
StateLicense IDTaxonomies
CT074581208800000X
FL0050340208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50796Medicare UPIN
FL03694ZMedicare ID - Type Unspecified