Provider Demographics
NPI:1669647533
Name:GOLDBERG, ELIZABETH JEAN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JEAN
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:ARNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 141448
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-1448
Mailing Address - Country:US
Mailing Address - Phone:352-478-4700
Mailing Address - Fax:352-225-3399
Practice Address - Street 1:6800 NW 9TH BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4253
Practice Address - Country:US
Practice Address - Phone:352-478-4700
Practice Address - Fax:352-225-3399
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN92508982084P0800X
FLARNP9250898363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000702500Medicaid
BJ271ZMedicare PIN
FL000702500Medicaid