Provider Demographics
NPI:1972530616
Name:GOLDSTEIN, WARREN S (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:S
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6421 CONGRESS AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2858
Mailing Address - Country:US
Mailing Address - Phone:352-688-0800
Mailing Address - Fax:352-462-3277
Practice Address - Street 1:11373 CORTEZ BLVD STE 408
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5406
Practice Address - Country:US
Practice Address - Phone:352-688-0800
Practice Address - Fax:352-462-3277
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME56888207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F66079Medicare UPIN
FL23303ZMedicare PIN