Healthcare Provider Details

I. General information

NPI: 1518803261
Provider Name (Legal Business Name): HERAS GOLDEN YEARS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 S UNIVERSITY DR STE 118
DAVIE FL
33328-5309
US

IV. Provider business mailing address

5400 S UNIVERSITY DR STE 118
DAVIE FL
33328-5309
US

V. Phone/Fax

Practice location:
  • Phone: 954-526-1540
  • Fax: 954-827-0205
Mailing address:
  • Phone: 954-526-1540
  • Fax: 954-827-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JUAN ANTONIO RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-956-8107