Provider Demographics
NPI:1952399149
Name:GOLD, RONALD S (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:S
Last Name:GOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3451
Mailing Address - Country:US
Mailing Address - Phone:561-967-2225
Mailing Address - Fax:561-434-7777
Practice Address - Street 1:4611 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3451
Practice Address - Country:US
Practice Address - Phone:561-967-2225
Practice Address - Fax:561-434-7777
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380795900Medicaid
FL380795900Medicaid
T33430Medicare UPIN