OrganizationActive
Golden Age Physician Specialists LLC
NPI 1104520717 · Internal Medicine Physician · Crystal River, FL
Provider details
- NPI number
- 1104520717
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dacelin St. Martin, Provider(352) 684-8736
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6405 W Gulf to Lake Hwy
Crystal River, FL 34429-9354
Phone: (352) 684-8736
Street-level locationGet directions
Mailing address
Po Box 2066
Lecanto, FL 34460-2066
Other names (DBA / former)
- Other name
- Gaps
Registry dates
- Enumerated
- 2023-03-28
- Last updated
- 2023-05-18
- Certified
- 2023-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.