Provider Demographics
NPI:1952687741
Name:GOLDSHMID, MICHAL S (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHAL
Middle Name:S
Last Name:GOLDSHMID
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 SIENNA RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4355
Mailing Address - Country:US
Mailing Address - Phone:954-319-4778
Mailing Address - Fax:
Practice Address - Street 1:2774 WEST DAVIE BLVD
Practice Address - Street 2:RIVERLAND MEDICAL CENTERS,INC.
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:954-791-3458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105985363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical