Healthcare Provider Details
I. General information
NPI: 1780249094
Provider Name (Legal Business Name): GOLDORO DEVELOPMENTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2019
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1799 S FEDERAL HWY
BOCA RATON FL
33432-7412
US
IV. Provider business mailing address
1799 S FEDERAL HWY
BOCA RATON FL
33432-7412
US
V. Phone/Fax
- Phone: 561-587-0337
- Fax: 561-687-5601
- Phone: 561-210-9568
- Fax: 561-404-9645
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
KASSA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 904-610-4653