Provider Demographics
NPI:1619686227
Name:MW GOLDEN AGE CARE CORP
Entity Type:Organization
Organization Name:MW GOLDEN AGE CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-454-2568
Mailing Address - Street 1:2300 W 84TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5772
Mailing Address - Country:US
Mailing Address - Phone:305-454-2568
Mailing Address - Fax:
Practice Address - Street 1:2300 W 84TH ST STE 212
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5772
Practice Address - Country:US
Practice Address - Phone:305-454-2568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care