Golden Gate Family Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME74588 Issued in FL

Legal business name

GOLDEN GATE FAMILY CLINIC

Practice address

5475 Golden Gate Pkwy
Suite # 7
Naples, FL 34116-7529

Phone

(239) 775-3100

Fax

(239) 775-3107

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Vava Y. Nyanudor, M.D.NPI 1104922053

Title

President

Phone

(239) 775-3100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Vava Yao Nyanudor, M.D.

  • Family Medicine Physician
  • Naples, FL
  • NPI 1104922053
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1598934838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 GOLDEN GATE PKWY",
            "address_2": "SUITE # 7",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341167529",
            "telephone_number": "239-775-3100",
            "fax_number": "239-775-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 GOLDEN GATE PKWY",
            "address_2": "SUITE # 7",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341167529",
            "telephone_number": "239-775-3100",
            "fax_number": "239-775-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN GATE FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "NYANUDOR",
        "authorized_official_first_name": "VAVA",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-775-3100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Chiropractic Center PA
• Golden Chiropractic LLC
• Golden Gate Chiropractic Center Inc
• Golden Gate Chiropractic Inc
• Golden Gate Chiropractic Inc.
• Golden Gate Pharmacy, Inc
• Golden Gate Pkwy Pain & Injury Rehab., Inc.
• Golden Heart Healthcare LLC
• Golden Management Services of Naples
• Golden Palms Care Center LLC

• Family Medicine Physician in Naples, FL
• Providers in Naples, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.