Provider Demographics
NPI:1881838001
Name:GOLDIN, TATYANA (DO)
Entity Type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:
Last Name:GOLDIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 NW 33RD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6349
Mailing Address - Country:US
Mailing Address - Phone:877-868-4827
Mailing Address - Fax:877-283-0663
Practice Address - Street 1:5430 NW 33RD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6349
Practice Address - Country:US
Practice Address - Phone:877-868-4827
Practice Address - Fax:877-283-0663
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10425207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine