Golden Age Physician Specialists LLC
NPI 1104520717 · Internal Medicine Physician · Crystal River, FL
Golden Age Physician Specialists LLC is a Internal Medicine Physician organization in Crystal River, FL (NPI 1104520717).
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
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
Mailing address
Other names (DBA / former)
- Other name
- Gaps
Registry dates
- Enumerated
- 2023-03-28
- Last updated
- 2023-05-18
- Certified
- 2023-05-18
Frequently asked questions
- What is Golden Age Physician Specialists LLC's NPI number?
- Golden Age Physician Specialists LLC's National Provider Identifier (NPI) is 1104520717, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Golden Age Physician Specialists LLC?
- Golden Age Physician Specialists LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Golden Age Physician Specialists LLC located?
- Golden Age Physician Specialists LLC's practice location on file with NPPES is 6405 W Gulf to Lake Hwy, Crystal River, FL 34429-9354.
- What is Golden Age Physician Specialists LLC's phone number?
- The practice phone number listed in the NPPES registry for Golden Age Physician Specialists LLC is (352) 684-8736.
- Who is the authorized official for Golden Age Physician Specialists LLC?
- The authorized official listed on Golden Age Physician Specialists LLC's NPPES record is Dacelin St. Martin, Provider. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Golden Age Physician Specialists LLC's NPI active?
- Yes — Golden Age Physician Specialists LLC's NPI (1104520717) is active in the NPPES registry as of the last update on 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.