MEDICARE: GOLDEN SWAN BY THE LAKE

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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1942126768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN SWAN BY THE LAKE

Provider Business Mailing Address
First Line	:	17331 SPRING TREE LN
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1106
Country	:	US
Telephone Number	:	954-867-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	17331 SPRING TREE LN
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1106
Country	:	US
Telephone Number	:	954-867-8080
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. KATYA VUSCAN
Credential	:
Telephone Number	:	954-867-8080

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “GOLDEN SWAN BY THE LAKE ” Practice Location

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