Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Golden Age Physician Specialists LLC

Organization Family Medicine Physician · NPI 1104520717

Golden Age Physician Specialists LLC is a Family Medicine Physician in Crystal River, Florida. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6405 W Gulf To Lake Hwy
Crystal River, FL 34429-9354
Phone: (352) 684-8736
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1104520717
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dacelin St. Martin — Provider · (352) 684-8736
Other names Gaps
NPI enumeratedMarch 28, 2023
Last updated in NPPESMay 18, 2023
Certification dateMay 18, 2023
Mailing addressPo Box 2066, Lecanto, FL 34460-2066

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