Provider Demographics
NPI:1245402478
Name:GOLDEN MEDICAL & CHIROPRACTIC CARE, LLC
Entity Type:Organization
Organization Name:GOLDEN MEDICAL & CHIROPRACTIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-584-1550
Mailing Address - Street 1:700 W VINE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4203
Mailing Address - Country:US
Mailing Address - Phone:407-350-5913
Mailing Address - Fax:407-350-5918
Practice Address - Street 1:700 W VINE ST STE 101
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4203
Practice Address - Country:US
Practice Address - Phone:407-350-5913
Practice Address - Fax:407-350-5918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty