Organization
OUR GOLDEN MEDICAL CENTER
Active
Other names
JUAN G CAMAYD MD
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
12781 SW 42ND ST, STE H, MIAMI, FL 33175-3437
(305) 229-3990
Mailing address
12781 SW 42ND ST, STE H, MIAMI, FL 33175-3437
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME81667
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019113
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/22/2006
Last updated
08/22/2020
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