# MEDICAL GOLDEN CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073082236
- **Authorized official:** HECTOR J NIEVES-DAVILA (CEO)
- **Authorized official phone:** (787) 955-6920

## Contact information

- **Practice address:** 3230 HILLSDALE LN, KISSIMMEE, FL 34741-7562
- **Practice address phone:** (407) 413-3200
- **Practice address fax:** (407) 350-3007
- **Mailing address:** 11310 S ORANGE BLOSSOM TRL STE 109, ORLANDO, FL 32837-9421
- **Mailing address phone:** (407) 413-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2018
- **Last updated:** 04/10/2026