Provider Demographics
NPI:1760070593
Name:GOLDWASSER, A NORMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:A
Middle Name:NORMAN
Last Name:GOLDWASSER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 NAUTILUS CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2817
Mailing Address - Country:US
Mailing Address - Phone:786-877-9977
Mailing Address - Fax:
Practice Address - Street 1:4545 NAUTILUS CT
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2817
Practice Address - Country:US
Practice Address - Phone:786-877-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4605103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty