Provider Demographics
NPI:1548773039
Name:GOLDUNN YEARS GERIATRIC MEDICINE INC
Entity Type:Organization
Organization Name:GOLDUNN YEARS GERIATRIC MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG-DUNNETT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-616-0075
Mailing Address - Street 1:5355 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4540
Mailing Address - Country:US
Mailing Address - Phone:352-616-0075
Mailing Address - Fax:352-616-0072
Practice Address - Street 1:5355 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4540
Practice Address - Country:US
Practice Address - Phone:352-616-0075
Practice Address - Fax:352-616-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty