Basic Information
Provider Information
NPI: 1972530616
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOLDSTEIN
FirstName: WARREN
MiddleName: S.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10002 PRINCESS PALM AVE STE 332
Address2:  
City: TAMPA
State: FL
PostalCode: 336198327
CountryCode: US
TelephoneNumber: 8135717184
FaxNumber: 8136544695
Practice Location
Address1: 7425 MONIKA MANOR DR
Address2:  
City: TAMPA
State: FL
PostalCode: 336255814
CountryCode: US
TelephoneNumber: 8138798045
FaxNumber: 8139603299
Other Information
ProviderEnumerationDate: 06/27/2006
LastUpdateDate: 04/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XME56888FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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