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Organization
VILLAGE GROUP MANAGEMENT CORP.
Active
Organization
VILLAGE GROUP MANAGEMENT CORP.
Active
Other names
Century Village Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENE GODOY M.D. (MEDICAL DOCTOR MEDICAL DIRECTOR)
(954) 433-9501
Entity
Organization
Contact information
Practice address
13550 SW 10TH STREET, STE B, PEMBROKE PINES, FL 33027
(954) 433-9501
(954) 433-8035
Mailing address
13550 SW 10TH STREET, STE B, PEMBROKE PINES, FL 33027
(954) 433-9501
(954) 433-8035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0065758
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110819
HUMANA HEALTHPLAN
FL
05
—
376822800
—
FL
01
—
K2474
VISTA HEALTHPLAN
FL
Enumeration date
08/24/2008
Last updated
10/23/2008
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