Golden Age Physician Specialists LLC

NPI #1104520717 in Crystal River, Florida

Provider Information

NPI Number: 1104520717
Entity Type: Organization
Organization Name: Golden Age Physician Specialists LLC
Primary Specialty: Internal Medicine
Enumeration Date: Mar 28, 2023
Last Updated: May 18, 2023

Practice Location

Address: 6405 W GULF TO LAKE HWY
City: Crystal River
State: Florida
ZIP Code: 34429-9354
Phone: (352) 684-8736

Authorized Official

Name: DACELIN ST. MARTIN, MD
Title: PROVIDER
Phone: (352) 684-8736

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Internal Medicine	207R00000X	Primary

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