Healthcare Provider Details

I. General information

NPI: 1568969764
Provider Name (Legal Business Name): GOLDEN HOME CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W 76TH ST STE 211
HIALEAH FL
33016-5503
US

IV. Provider business mailing address

2100 W 76TH ST STE 211
HIALEAH FL
33016-5503
US

V. Phone/Fax

Practice location:
  • Phone: 786-355-8663
  • Fax:
Mailing address:
  • Phone: 786-355-8663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30211963
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number30211963
License Number StateFL

VIII. Authorized Official

Name: MARELYS SANCHEZ
Title or Position: OWNER
Credential:
Phone: 786-355-8663