Provider Demographics
NPI:1295032241
Name:GOLD CARE HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:GOLD CARE HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-5219
Mailing Address - Street 1:1502 W BUSCH BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7668
Mailing Address - Country:US
Mailing Address - Phone:813-443-5219
Mailing Address - Fax:813-443-5220
Practice Address - Street 1:1502 W BUSCH BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7668
Practice Address - Country:US
Practice Address - Phone:813-443-5219
Practice Address - Fax:813-443-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993825251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004053200Medicaid
FL10-9758OtherCMS CERTIFICATION NUMBER (CCN)