1245201425 NPI number — ANDRE J GOLINO MD AND ASSOCIATES PA

Table of content: (NPI 1245201425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245201425 NPI number — ANDRE J GOLINO MD AND ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDRE J GOLINO MD AND ASSOCIATES PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245201425
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 BUTLER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33407-6106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-832-6113
Provider Business Mailing Address Fax Number:
561-833-3003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 BUTLER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33407-6106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-832-6113
Provider Business Practice Location Address Fax Number:
561-833-3003
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOLINO
Authorized Official First Name:
ANDRE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
561-832-6113

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  1007 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6880174 . This is a "EVERCARE/UNITEDHEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5996694 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6800345 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 005996694 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3791029 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 490001325 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 079048600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0903770 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 675 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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