Organization Name: | FIDEL S. GOLDSON, DC PA |
NPI Number: | 1023480985 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FIDEL GOLDSON (PRESIDENT) |
Mailing Address: | 734 N State Road 7 Plantation |
State: | FL US |
Postal Code: | 333172129 |
Phone Number: | 9545843774 |
Fax Number: | 9545830497 |
NPI Enumeration Date: | 10/30/2015 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | PT19489 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |