Provider Demographics
NPI:1982698015
Name:GOLIN, ERNEST DENNIS (ATC,LMT,CSTS)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:DENNIS
Last Name:GOLIN
Suffix:
Gender:M
Credentials:ATC,LMT,CSTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 ARCHSTONE DR
Mailing Address - Street 2:UNIT 207
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4235
Mailing Address - Country:US
Mailing Address - Phone:813-887-1909
Mailing Address - Fax:813-887-1909
Practice Address - Street 1:5336 ARCHSTONE DR
Practice Address - Street 2:UNIT 207
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4235
Practice Address - Country:US
Practice Address - Phone:813-887-1909
Practice Address - Fax:813-887-1909
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL44225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist