Provider Demographics
NPI:1023273372
Name:GOLDBERG, STUART WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:WAYNE
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 POINTE REGAL CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1811
Mailing Address - Country:US
Mailing Address - Phone:303-859-4766
Mailing Address - Fax:
Practice Address - Street 1:6065 POINTE REGAL CIR APT 107
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-1811
Practice Address - Country:US
Practice Address - Phone:303-859-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor