Provider Demographics
NPI:1134362734
Name:DEBORAH GOLDMAN, O.D., P.A.
Entity type:Organization
Organization Name:DEBORAH GOLDMAN, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-792-3387
Mailing Address - Street 1:2205 STATE ROAD 7
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-792-3387
Mailing Address - Fax:561-792-8055
Practice Address - Street 1:2205 STATE ROAD 7
Practice Address - Street 2:SUITE 400
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-792-3387
Practice Address - Fax:561-792-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty