Glen Herbert Goldsmith, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA18509 Issued in FL

Practice address

4491 W Stable CT
Beverly Hills, FL 34465-4451

Phone

(727) 385-0771

NPI assigned

Apr 30, 2013

Last updated

Apr 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1518302876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4491 W STABLE CT",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654451",
            "telephone_number": "727-385-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 W STABLE CT",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654451",
            "telephone_number": "727-385-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "GLEN",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G & R Investment Group (G and R Community Care)
• Juan Galvan, MD
• Gautam Ganguly
• Shani Adia Gary, MA
• Stefanie Glover, MA, MS
• Marilyn Jo Green, P.T.
• Kimberly Griffin, LMT
• Jason M Haas
• Jerome L Hansen, PA
• Lauren Hartwell

• Physical Therapy Assistant in Beverly Hills, FL
• Providers in Beverly Hills, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.