# GOLDEN GATE MEDICAL GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GOLDEN GATE MENTAL HEALTH CORP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366041709
- **Authorized official:** DANIELA RUIZ ALVAREZ (PRESIDENT)
- **Authorized official phone:** (786) 755-2892

## Contact information

- **Practice address:** 1818 W FLAGLER ST, MIAMI, FL 33135-1915
- **Practice address phone:** (786) 755-2892
- **Practice address fax:** (305) 364-5767
- **Mailing address:** 1818 W FLAGLER ST, MIAMI, FL 33135-1915
- **Mailing address phone:** (786) 755-2897
- **Mailing address fax:** (305) 364-5767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0201X | Allergy & Immunology (Internal Medicine) Physician | — | NULL | — |
| 207RA0201X | Allergy & Immunology (Internal Medicine) Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2020
- **Last updated:** 03/21/2025