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General NPI Number Information
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NPI Number | 1265648216
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS FOR THE ELDERLY CORP
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 13184 S.W. 19TH TERR.
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-229-7007
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Fax | 305-693-5078
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Provider Business Mailing Address
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Address Line | 13184 S.W. 19TH TERR.
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-229-7007
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Fax | 305-693-5078
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | REYNIER RUIZ
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Credential |
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Telephone | 786-426-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 9923
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License Number State | FL
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