Provider Demographics
NPI:1245201425
Name:ANDRE J GOLINO MD AND ASSOCIATES PA
Entity type:Organization
Organization Name:ANDRE J GOLINO MD AND ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-832-6113
Mailing Address - Street 1:130 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6106
Mailing Address - Country:US
Mailing Address - Phone:561-832-6113
Mailing Address - Fax:561-833-3003
Practice Address - Street 1:130 BUTLER ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6106
Practice Address - Country:US
Practice Address - Phone:561-832-6113
Practice Address - Fax:561-833-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1007261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6880174OtherEVERCARE/UNITEDHEALTHCARE
5996694OtherAETNA
FL6800345OtherUNITED HEALTH CARE
005996694OtherAETNA US HEALTHCARE
3791029OtherCIGNA
FL490001325OtherRAILROAD MEDICARE
FL079048600Medicaid
0903770OtherCIGNA
FL675OtherBCBS
FLF1054Medicare PIN