Healthcare Provider Details

I. General information

NPI: 1235720558
Provider Name (Legal Business Name): GOLDEN WELLNESS CASE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27331 S DIXIE HWY
NARANJA FL
33032-8233
US

IV. Provider business mailing address

27331 S DIXIE HWY
NARANJA FL
33032-8233
US

V. Phone/Fax

Practice location:
  • Phone: 305-562-1983
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: NATALIA C BETANCOURT
Title or Position: OWNER
Credential:
Phone: 305-781-9682