Glen R. Goldfarb, M.D.

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

ME66028 Issued in FL

Practice address

620 10TH Street N.
St Petersburg, FL 33705-1407

Phone

(727) 824-8375

Fax

(727) 824-7140

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suncoast Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • St Petersburg, FL
  • NPI 1497866537
  NPD (past)
• Suncoast Medical Clinic LLC

  • Clinical Medical Laboratory
  • St Petersburg, FL
  • NPI 1649397662
  NPD (past)
• Suncoast Medical Clinic LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1760664882
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 4, 2016.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1548255151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12868",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337332868",
            "telephone_number": "727-824-8357",
            "fax_number": "727-824-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH STREET N.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-8375",
            "fax_number": "727-824-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "GLEN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "ME66028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261168600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faye Jessica-Maurine Golden, D.C.
• Terence Liam Golden, D.C.
• Neil Goldenberg, MD
• Talia Goldenberg, CRNA
• Goldenlifemanor
• Joshua Goldman, LCSW
• Marc Goldman, MD
• Micheyle Goldman, D.O.
• Sara Goldstein, MS, CGC
• Golfview Nursing Center LLC

• All providers in St Petersburg, FL
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.