Palm Harbor Internal Medicine and Pediatrics, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PALM HARBOR INTERNAL MEDICINE AND PEDIATRICS, PA

Practice address

3890 Tampa Rd
Suite 101
Palm Harbor, FL 34684-3676

Phone

(727) 789-5811

Fax

(727) 786-8417

NPI assigned

Apr 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary M Goldstein, M.D.NPI 1215995345

Title

President of Corporation

Phone

(727) 789-5811

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary M Goldstein, M.D.

  • Pediatrics Physician
  • Palm Harbor, FL
  • NPI 1215995345

  Internal Medicine

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1073570511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD",
            "address_2": "SUITE 101",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843676",
            "telephone_number": "727-789-5811",
            "fax_number": "727-786-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD",
            "address_2": "SUITE 101",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843676",
            "telephone_number": "727-789-5811",
            "fax_number": "727-786-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM HARBOR INTERNAL MEDICINE AND PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "727-789-5811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palm Harbor Dermatology PA
• Palm Harbor Family Counseling Center
• Palm Harbor Family Counseling Center Inc.
• Palm Harbor Family Dentistry
• Palm Harbor FL Opco LLC
• Palm Harbor Pediatric Urgent Care Center PA
• Palm Harbor Pediatrics PA
• Palm Harbor Physical Therapy
• Palm Harbor Plastic Surgery Center
• Palm Harbor Post Acute LLC

• Internal Medicine Physician in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.