Healthcare Provider Details

I. General information

NPI: 1720793920
Provider Name (Legal Business Name): GOLDEN LIFE SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5499 NOKOMIS CIR
ORLANDO FL
32839-7317
US

IV. Provider business mailing address

8865 COMMODITY CIR STE 14-103
ORLANDO FL
32819-9056
US

V. Phone/Fax

Practice location:
  • Phone: 407-706-7575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246YC3302X
TaxonomyPhysician Office Based Coding Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH FLETCHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 407-706-7575