Organization
GOLDEN PROFESSIONAL THERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARNALDO DE LA VEGA (VICE PRESIDENT)
(239) 931-4001
Entity
Organization
Contact information
Practice address
31 BARKLEY CIR, SUITE 1B, FORT MYERS, FL 33907-7628
(239) 931-4001
(239) 931-4002
Mailing address
31 BARKLEY CIR, SUITE 1B, FORT MYERS, FL 33907-7628
(239) 931-4001
(239) 931-4002
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
ME101292
FL
225700000X
Massage Therapist
Primary
MA63547
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000107700
—
FL
Enumeration date
10/21/2011
Last updated
10/21/2011
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