| Golden Years Behavioral Center Corp | |
|
12955 Sw 42nd St Ste 2 Miami FL 33175-2928 | |
| (859) 803-3561 | |
| Not Available |
| Full Name | Golden Years Behavioral Center Corp |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 12955 Sw 42nd St Ste 2, Miami, Florida |
| Authorized Official Name and Position | Gleys J Perez Martinez (VP) |
| Authorized Official Contact | 7026900319 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Years Behavioral Center Corp 12955 Sw 42nd St Ste 2 Miami FL 33175-2928 Ph: (786) 491-4947 | Golden Years Behavioral Center Corp 12955 Sw 42nd St Ste 2 Miami FL 33175-2928 Ph: (859) 803-3561 |
| NPI Number | 1447859137 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 04/13/2023 |
| Medicare PECOS PAC ID | 1951706662 |
|---|---|
| Medicare Enrollment ID | O20210818002915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447859137 | NPI | - | NPPES |
| Provider Name | Ana Cristina Uribe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215214960 PECOS PAC ID: 3476700600 Enrollment ID: I20120823000339 |
| Provider Name | Kevin Fitzgerald |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891923744 PECOS PAC ID: 6204980717 Enrollment ID: I20160822001548 |
| Provider Name | Tania Pilar Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962971465 PECOS PAC ID: 7911337183 Enrollment ID: I20200611001683 |
| Provider Name | Lissette Dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710505482 PECOS PAC ID: 0749691517 Enrollment ID: I20201130001601 |
| Provider Name | Maydenis Monzon |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336790294 PECOS PAC ID: 6103212683 Enrollment ID: I20220409000207 |
| Provider Name | Roxana Cevallos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760822811 PECOS PAC ID: 9032506746 Enrollment ID: I20220427003168 |
| Provider Name | Alberto Oyaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558068403 PECOS PAC ID: 6103270038 Enrollment ID: I20230927000763 |
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