Provider Demographics
NPI:1245919240
Name:GOLDEN ORTHOPEDIC KNEE HIP SHOULDER AND FOOT CENTER INC
Entity type:Organization
Organization Name:GOLDEN ORTHOPEDIC KNEE HIP SHOULDER AND FOOT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-637-4200
Mailing Address - Street 1:9970 CENTRAL PARK BLVD N STE 300
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2237
Mailing Address - Country:US
Mailing Address - Phone:561-488-2200
Mailing Address - Fax:
Practice Address - Street 1:13590 S JOG RD STE 7
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3807
Practice Address - Country:US
Practice Address - Phone:561-637-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty