Healthcare Provider Details

I. General information

NPI: 1891944591
Provider Name (Legal Business Name): NEW LIFE NURSING CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 W 49TH PL STE 492
HIALEAH FL
33012-3196
US

IV. Provider business mailing address

1490 W 49TH PL STE 492
HIALEAH FL
33012-3196
US

V. Phone/Fax

Practice location:
  • Phone: 305-828-3577
  • Fax: 305-828-3578
Mailing address:
  • Phone: 305-828-3577
  • Fax: 305-828-3578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. MERCEDES SOLIS
Title or Position: ADMINISTRATOR / OWNER
Credential:
Phone: 305-828-3577