Healthcare Provider Details

I. General information

NPI: 1295644052
Provider Name (Legal Business Name): GOLDEN AGE TRANSPORTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9542 KINGSBURY CT
WINDERMERE FL
34786-8211
US

IV. Provider business mailing address

9542 KINGSBURY CT
WINDERMERE FL
34786-8211
US

V. Phone/Fax

Practice location:
  • Phone: 516-857-5087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: EUKANE GABRIEL
Title or Position: OWNER
Credential:
Phone: 516-857-5087