Provider Demographics
NPI:1346208485
Name:GOLDEN MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:GOLDEN MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:LAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-967-6061
Mailing Address - Street 1:6365 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5952
Mailing Address - Country:US
Mailing Address - Phone:954-967-6061
Mailing Address - Fax:954-967-6062
Practice Address - Street 1:6365 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5952
Practice Address - Country:US
Practice Address - Phone:954-967-6061
Practice Address - Fax:954-967-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes209800000XAllopathic & Osteopathic PhysiciansLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9085Medicare ID - Type UnspecifiedPART B