DR. JACOB H GOLDBERGER (NPI# 1093713489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093713489 |
| Entity Type | Individual |
| Full Name | DR. JACOB H GOLDBERGER |
| Credential | MD |
| Practice Address |
4571 Colonial Blvd Suite 210 Fort Myers FL 33966-1156 |
| Mailing Address |
2160 Colonial Blvd Payer Contracting and Relations Fort Myers FL 33907-1410 |
| Practice Telephone | 2392747600 |
| Practice Fax Number | 2392747601 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2017-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | ME 35410 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 039133600 | 05 | |
| FL | WELLCARE | 1278209 | 01 |
| FL | BCBS FL PROVIDER # | 95439 | 01 |
| FL | CIGNA PROVIDER # | 7365988 | 01 |
| FL | RAILROAD MEDICARE | P00413910 | 01 |
| Street Address |
4571 COLONIAL BLVD SUITE 210 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33966-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760963292 | Colonial Outpatient Surgery Center, LLC | Clinic/Center | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2018-08-23 |
| 1275917304 | 21st Century Oncology LLC | Urology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2015-07-18 |
| 1528442332 | Genesiscare of Florida LLC | Otolaryngology | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2015-07-13 |
| 1306274063 | Mark Monzone | Physician Assistant | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2013-10-16 |
| 1588005383 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2013-07-10 |
| 1700140878 | Specialists In Urology, P.a. | Urology | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966-1156 | 2012-07-03 |
| 1912209800 | Specialists In Urology Surgery Center LLC | Clinic/Center | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966 | 2010-11-26 |
| 1861707275 | Megan Lavender Menster | Nurse Practitioner | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2010-08-10 |
| 1124258983 | Meagan M Walton | Nurse Practitioner | 4571 Colonial Blvd, Suite 100, Fort Myers, FL 33966-1156 | 2009-07-15 |
| 1801038070 | Scott Von Larson | Otolaryngology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2009-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
| 1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
| 1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
| 1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
| 1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
| 1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
| 1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
| 1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
| 1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
| 1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
| Find all providers in zip 33966 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301263 | Heather Marie Gable | Surgery | 6150 Diamond Centre Ct # 1300, Fort Myers, FL 33912-4367 | 2020-09-21 |
| 1891036810 | Genesiscare Usa of Florida LLC | Surgery | 13691 Metro Pkwy Ste 350, Metro Medical Plaza, Fort Myers, FL 33912-4351 | 2013-03-15 |
| 1780967430 | Surgical Healing Arts Center, LLC | Surgery | 6150 Diamond Centre Court, Suite 1301, Fort Myers, FL 33912 | 2011-09-20 |
| 1649413907 | Bart Stanley Cuderman | Surgery | 14640 Double Eagle Ct, Fort Myers, FL 33912-1716 | 2009-04-15 |
| 1780835959 | Surgical Consultants of Southwest Florida, LLC | Surgery | 4519 Tilton Ct, Fort Myers, FL 33907-1214 | 2008-10-07 |
| 1912161670 | Brian D Kurland M D P A | Surgery | 13782 Plantation Rd Ste 103, Fort Myers, FL 33912 | 2008-07-11 |
| 1740490002 | Bruce Cleaveland Bacon | Surgery | 6932 Old Whiskey Creek Dr, Fort Myers, FL 33919-1827 | 2007-05-23 |
| 1346468170 | Claude P Lieber | Surgery | 482 Keenan Ct, Fort Myers, FL 33919-3110 | 2007-04-24 |
| 1588782585 | Gilbert Abou Lahoud | Surgery | 6150 Diamond Centre Ct Unit 1200, Fort Myers, FL 33912 | 2007-03-27 |
| 1760580054 | David T Rideout | Surgery | 3050 Champion Ring Rd, Fort Myers, FL 33905-5599 | 2006-09-20 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33966 |
Please comment or provide details below to improve the information on DR. JACOB H GOLDBERGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.