Healthcare Provider Details

I. General information

NPI: 1548170244
Provider Name (Legal Business Name): GOLDEN COMMUNITY HEALTH SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 MEMORIAL HWY STE 201
TAMPA FL
33615-4573
US

IV. Provider business mailing address

8329 W HANNA AVE
TAMPA FL
33615-3248
US

V. Phone/Fax

Practice location:
  • Phone: 702-885-9651
  • Fax:
Mailing address:
  • Phone: 702-885-9651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARIANELYS CANNAVACCIUOLO
Title or Position: ADMINISTRATOR/ CEO
Credential:
Phone: 702-885-9651