Provider Demographics
NPI:1841347762
Name:PETER A GOLD PSY D P A
Entity type:Organization
Organization Name:PETER A GOLD PSY D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:954-445-7152
Mailing Address - Street 1:2925 CARDINAL DR STE F
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1979
Mailing Address - Country:US
Mailing Address - Phone:954-445-7152
Mailing Address - Fax:
Practice Address - Street 1:2770 INDIAN RIVER BLVD FL 3
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4299
Practice Address - Country:US
Practice Address - Phone:954-445-7152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7322103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty