Golden Meridian LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

GOLDEN MERIDIAN LLC

Practice address

17501 N Dale Mabry Hwy # D
Lutz, FL 33548-4521

Phone

(813) 573-2756

NPI assigned

Aug 22, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soh Young Park, AP, DOMNPI 1104662873

Title

President/Owner

Phone

(813) 573-2756

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soh Young Park, AP,DOM

  • Acupuncturist
  • Lutz, FL
  • NPI 1104662873
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1013740299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 BURKETT CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346207",
            "telephone_number": "813-573-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17501 N DALE MABRY HWY # D",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484521",
            "telephone_number": "813-573-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN MERIDIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SOH YOUNG",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "813-573-2756",
        "authorized_official_credential": "AP, DOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idljona Gllava, M.D.
• Gloria Alf, Inc.
• Kayla Glover
• Ashley Goble
• Tracy Goldberg, DNP
• Courtney P Goldstein
• Gomes Place LLC
• Christina Catherine Gomez, D.O.
• Dariel A Gomez
• Lars Gomoll

• Pain Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.