Provider Demographics
NPI:1922043199
Name:GOLDENBERG, JAMES N (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:N
Last Name:GOLDENBERG
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 1:610 N LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3121
Mailing Address - Country:US
Mailing Address - Phone:561-313-4489
Mailing Address - Fax:
Practice Address - Street 1:130 JFK DR STE 201
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1142
Practice Address - Country:US
Practice Address - Phone:561-968-2933
Practice Address - Fax:561-209-2923
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0592022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374781600Medicaid
F52548Medicare UPIN
FL374781600Medicaid