Healthcare Provider Details

I. General information

NPI: 1306739719
Provider Name (Legal Business Name): GOLDEN BROOK SENIOR CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16650 W DIXIE HWY
NORTH MIAMI BEACH FL
33160-3713
US

IV. Provider business mailing address

407 WILLOUGHBY AVE
BROOKLYN NY
11205-4590
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-0288
  • Fax: 718-946-6089
Mailing address:
  • Phone: 718-470-0288
  • Fax: 718-946-6089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL RETEK
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 718-470-0288