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Contact Information

DIANE L GOLDWATER, M.D., PH.D.
830 A1A NORTH SUITE 13
#105
PONTE VEDRA BEACH, FL32082
 Phone: 310-535-1778
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2083S0010X 84 Physician/Preventive Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for DIANE L GOLDWATER · (Female)

NPI Number 1740350776
Status Active
Credentials M.D., PH.D.
Entity Individual
Enumeration date 11/08/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A045037
  • FL License # ME63438
  • TX License # H4354
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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