Provider Demographics
NPI:1942370697
Name:DEBORAH GOLDSMITH DC PA
Entity type:Organization
Organization Name:DEBORAH GOLDSMITH DC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-953-3030
Mailing Address - Street 1:1071 S TUTTLE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-8105
Mailing Address - Country:US
Mailing Address - Phone:941-953-3030
Mailing Address - Fax:941-953-3044
Practice Address - Street 1:1071 S TUTTLE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-8105
Practice Address - Country:US
Practice Address - Phone:941-953-3030
Practice Address - Fax:941-953-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70267OtherBCBS
FLU90671Medicare UPIN
FLAB546Medicare ID - Type UnspecifiedGROUP NUMBER