Provider Demographics
NPI:1730160292
Name:GOLD, LOUIS DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:DAVID
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9080 KIMBERLY BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2862
Mailing Address - Country:US
Mailing Address - Phone:561-477-7150
Mailing Address - Fax:561-477-7161
Practice Address - Street 1:9080 KIMBERLY BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2862
Practice Address - Country:US
Practice Address - Phone:561-477-7150
Practice Address - Fax:561-477-7161
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME705572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B80515Medicare UPIN
FL05355Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.