Provider Demographics
NPI:1851580997
Name:GOLD, JARED S (MD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:S
Last Name:GOLD
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 1:11645 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3155
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:
Practice Address - Street 1:11645 BISCAYNE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3155
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110190208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003731100Medicaid
FL003731100Medicaid