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General NPI Number Information
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NPI Number | 1013589324
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Entity Type | Organization
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Legal Business Name | GOLDEN MIRACLE, INC
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 7900 OAK LN STE 401
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City | MIAMI LAKES
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State | FL
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Zip | 33016-6001
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Country | US
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Telephone | 954-862-2236
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Fax | 954-944-0822
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Provider Business Mailing Address
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Address Line | 14601 SW 29TH ST STE 110
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City | MIRAMAR
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State | FL
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Zip | 33027-4715
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Country | US
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Telephone | 954-862-2236
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Fax | 954-944-0822
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BRENO CARDOSO
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Credential |
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Telephone | 954-862-2236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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