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NPI Code Detail

MEDICARE: SOUTH FLORIDA GOLDEN AGE CARE PA

MEDICARE: SOUTH FLORIDA GOLDEN AGE CARE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME101725FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730399437OTHERFLIND NPI

General Provider Information

NPI Number : 1740700228
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH FLORIDA GOLDEN AGE CARE PA
Provider Business Mailing Address
First Line : 5258 LINTON BLVD STE 204
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-6529
Country : US
Telephone Number : 561-509-0979
Fax Number :
Provider Business Practice Location Address
First Line : 5258 LINTON BLVD STE 204
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-6529
Country : US
Telephone Number : 561-509-0979
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MANUEL A ESPINEL
Credential : MD
Telephone Number : 561-509-0979
Provider Enumeration Date : 06/26/2017
Last Update Date : 07/21/2022

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Directions to “SOUTH FLORIDA GOLDEN AGE CARE PA ” Practice Location

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