Provider Demographics
NPI:1083055263
Name:GOLDEN YEARS OF SARASOTA LLC
Entity Type:Organization
Organization Name:GOLDEN YEARS OF SARASOTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:OSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:941-993-2663
Mailing Address - Street 1:1781 MELLON WAY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2947
Mailing Address - Country:US
Mailing Address - Phone:941-993-2663
Mailing Address - Fax:
Practice Address - Street 1:1781 MELLON WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2947
Practice Address - Country:US
Practice Address - Phone:941-993-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA98215311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1457799611OtherNATIONAL PROVIDER IDENTIFIER