NPIMap

Organization Active NPI

Golden Age Home Health Agency, Corp

  • Home Health Agency
  • Fort Myers, FL
National Provider Identifier
1740566108
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOLDEN AGE HOME HEALTH AGENCY, CORP
Practice address
7370 College Pkwy Ste 305
Fort Myers, FL 33907-5501
Phone
(239) 325-8586
Fax
(239) 236-7287
NPI assigned
Oct 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Mrs. Zaida Lis Torres
Title
Owner/Cfo
Phone
(786) 447-6491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

7370 College Pkwy Ste 305
Fort Myers, FL 33907-5501

Mailing address

7370 College Pkwy Ste 305
Fort Myers, FL 33907-5501
Phone (239) 325-8586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120614000599 FL Part A Provider - Home Health Agency 7113181587 Practice locations: Fort Myers, FL

Home health agency certification: CCN 683125

Legal name
GOLDEN AGE HOME HEALTH AGENCY, CORP
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 19, 2013
Last certification
Nov 4, 2016
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 2, 2011 in FL
Enrollment address
7370 College Pkwy
Ste 305
Fort Myers, FL 33907-5501

Care Compare: Home health agency

Medicare Care Compare
Listed as
Golden Age Home Health Agency CorpCCN 683125 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Nov 19, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2032526Golden Age Home Health Agency Corp7370 College Pkwy, Ste 305, Fort Myers, FL 33907Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory

Locations

7370 College Pkwy
Ste 305
Fort Myers, FL 33907
Phone (239) 325-8586

391 Lee Blvd
Ste 100
Lehigh Acres, FL 33936
Phone (239) 368-4899

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Zaida Torres Individual 5% Or Greater Direct Ownership Interest May 2, 2011 100%
Corporate OfficerPresident May 2, 2011 100%
W-2 Managing EmployeeAdm May 1, 2019 100%

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1740566108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7370 COLLEGE PKWY STE 305",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075501",
            "telephone_number": "239-325-8586",
            "fax_number": "239-236-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 COLLEGE PKWY STE 305",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075501",
            "telephone_number": "239-325-8586",
            "fax_number": "239-236-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HOME HEALTH AGENCY, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "ZAIDA",
        "authorized_official_middle_name": "LIS",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "786-447-6491",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.