Provider Demographics
NPI:1427272855
Name:GOLDBERG, DANA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:224 CHIMNEY CORNER LN
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4800
Mailing Address - Country:US
Mailing Address - Phone:561-691-8088
Mailing Address - Fax:561-328-9683
Practice Address - Street 1:224 CHIMNEY CORNER LN
Practice Address - Street 2:SUITE 1002
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4800
Practice Address - Country:US
Practice Address - Phone:561-691-8088
Practice Address - Fax:561-328-9683
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2012-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH57.008763208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHH145Medicare PIN