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General NPI Number Information
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NPI Number | 1548653876
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Entity Type | Organization
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Legal Business Name | GOLDEN HEART THERAPY, INC.
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 1104 RUSH CT
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City | CELEBRATION
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State | FL
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Zip | 34747-4874
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Country | US
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Telephone | 407-505-8521
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 RUSH CT
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City | CELEBRATION
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State | FL
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Zip | 34747-4874
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Country | US
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Telephone | 407-505-8521
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GENEFE LAGUNA HUTCHINSON
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Credential | DPT
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Telephone | 813-298-5696
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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 | PT12484
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT11594
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License Number State | FL
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