Provider Demographics
NPI:1427648286
Name:GOLDEN AGE MGT SERVICES INC
Entity type:Organization
Organization Name:GOLDEN AGE MGT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOMEZ NARBONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-616-4510
Mailing Address - Street 1:1421 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-4860
Mailing Address - Country:US
Mailing Address - Phone:786-616-4510
Mailing Address - Fax:
Practice Address - Street 1:14343 COMMERCE WAY STE 8
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1502
Practice Address - Country:US
Practice Address - Phone:786-616-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)