Provider Demographics
NPI:1669638342
Name:GOLPEA INC
Entity Type:Organization
Organization Name:GOLPEA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-789-2046
Mailing Address - Street 1:400 S DIXIE HWY
Mailing Address - Street 2:120
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5518
Mailing Address - Country:US
Mailing Address - Phone:561-368-3472
Mailing Address - Fax:
Practice Address - Street 1:400 S DIXIE HWY
Practice Address - Street 2:120
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5518
Practice Address - Country:US
Practice Address - Phone:561-368-3472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty