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General NPI Number Information
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NPI Number | 1740566108
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Entity Type | Organization
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Legal Business Name | GOLDEN AGE HOME HEALTH AGENCY, CORP
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 7370 COLLEGE PKWY STE 305
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City | FORT MYERS
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State | FL
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Zip | 33907-5501
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Country | US
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Telephone | 239-325-8586
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Fax | 239-236-7287
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Provider Business Mailing Address
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Address Line | 7370 COLLEGE PKWY STE 305
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City | FORT MYERS
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State | FL
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Zip | 33907-5501
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Country | US
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Telephone | 239-325-8586
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Fax | 239-236-7287
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Authorized Official
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Title or Position | OWNER/CFO
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Name | MRS. ZAIDA LIS TORRES
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Credential |
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Telephone | 786-447-6491
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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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