Provider Demographics
NPI:1568870855
Name:GOLDEN HEALTH GROUP
Entity Type:Organization
Organization Name:GOLDEN HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-818-1405
Mailing Address - Street 1:PO BOX 1562
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1562
Mailing Address - Country:US
Mailing Address - Phone:787-818-1405
Mailing Address - Fax:787-818-1400
Practice Address - Street 1:65 CALLE PEDRO SANTOS
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-1562
Practice Address - Country:US
Practice Address - Phone:787-818-1405
Practice Address - Fax:787-818-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty