Provider Demographics
NPI:1548653876
Name:GOLDEN HEART THERAPY, INC.
Entity type:Organization
Organization Name:GOLDEN HEART THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GENEFE
Authorized Official - Middle Name:LAGUNA
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:813-298-5696
Mailing Address - Street 1:1104 RUSH CT
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4874
Mailing Address - Country:US
Mailing Address - Phone:407-505-8521
Mailing Address - Fax:
Practice Address - Street 1:1104 RUSH CT
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4874
Practice Address - Country:US
Practice Address - Phone:407-505-8521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12484251E00000X
FLPT11594251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health