Provider Demographics
NPI:1336311570
Name:GOLDEN LIFE HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:GOLDEN LIFE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-220-9300
Mailing Address - Street 1:10250 SW 56TH ST
Mailing Address - Street 2:SUITE A201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7069
Mailing Address - Country:US
Mailing Address - Phone:786-220-9300
Mailing Address - Fax:786-220-9301
Practice Address - Street 1:10250 SW 56TH ST
Practice Address - Street 2:SUITE A201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7069
Practice Address - Country:US
Practice Address - Phone:786-220-9300
Practice Address - Fax:786-220-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health