# VILLAGE GROUP MANAGEMENT CORP.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Century Village Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376790121
- **Authorized official:** DR. GENE GODOY M.D. (MEDICAL DOCTOR MEDICAL DIRECTOR)
- **Authorized official phone:** (954) 433-9501

## Contact information

- **Practice address:** 13550 SW 10TH STREET, STE B, PEMBROKE PINES, FL 33027
- **Practice address phone:** (954) 433-9501
- **Practice address fax:** (954) 433-8035
- **Mailing address:** 13550 SW 10TH STREET, STE B, PEMBROKE PINES, FL 33027
- **Mailing address phone:** (954) 433-9501
- **Mailing address fax:** (954) 433-8035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME0065758 | FL | Yes |

## Other

- **Enumeration date:** 08/24/2008
- **Last updated:** 10/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 110819 | HUMANA HEALTHPLAN | FL |
| 05 | — | 376822800 | — | FL |
| 01 | — | K2474 | VISTA HEALTHPLAN | FL |