Provider Demographics
NPI:1205412376
Name:GOLDEN YEARS PARADISE, INC.
Entity Type:Organization
Organization Name:GOLDEN YEARS PARADISE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-608-2130
Mailing Address - Street 1:2104 SW 106TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7944
Mailing Address - Country:US
Mailing Address - Phone:786-633-5123
Mailing Address - Fax:786-633-5123
Practice Address - Street 1:2104 SW 106TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7944
Practice Address - Country:US
Practice Address - Phone:786-633-5123
Practice Address - Fax:786-633-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13573OtherAHCA