MEDICARE: NEW LIFE HOME HEALTH AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992408	FL

General Provider Information

NPI Number	:	1518990217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE HOME HEALTH AGENCY INC

Provider Business Mailing Address
First Line	:	7490 SW 23RD ST
Second Line	:	SUITE 201
City	:	MIAMI
State	:	FL
Zip	:	33155-1417
Country	:	US
Telephone Number	:	305-266-6060
Fax Number	:	305-266-6080

Provider Business Practice Location Address
First Line	:	7490 SW 23RD ST
Second Line	:	SUITE 201
City	:	MIAMI
State	:	FL
Zip	:	33155-1417
Country	:	US
Telephone Number	:	305-266-6060
Fax Number	:	305-266-6080

Authorized Official
Title or Position	:	CFO OWNER
Name	:	MS. VIOLETA CRISTINA FERNANDEZ
Credential	:
Telephone Number	:	305-266-6060

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/15/2010

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