Provider Demographics
NPI:1780914960
Name:STEVEN S. GOLDBERG, MD PL
Entity type:Organization
Organization Name:STEVEN S. GOLDBERG, MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-348-4400
Mailing Address - Street 1:6376 PINE RIDGE RD STE 430
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3905
Mailing Address - Country:US
Mailing Address - Phone:239-316-7600
Mailing Address - Fax:239-316-7509
Practice Address - Street 1:6376 PINE RIDGE RD # 430
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3905
Practice Address - Country:US
Practice Address - Phone:239-316-7600
Practice Address - Fax:239-316-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6377460001332B00000X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6377460001OtherMEDICARE DME PIN
FLDQ0641OtherRAILROAD MEDICARE
FL=========OtherEIN
FL6377460001Medicare NSC
FL6377460001OtherMEDICARE DME PIN
FL=========OtherEIN