Healthcare Provider Details

I. General information

NPI: 1104792019
Provider Name (Legal Business Name): NEW LIFE REHAB & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W 16TH AVE STE 140U
HIALEAH FL
33012-4662
US

IV. Provider business mailing address

3750 W 16TH AVE STE 140U
HIALEAH FL
33012-4662
US

V. Phone/Fax

Practice location:
  • Phone: 561-647-2326
  • Fax:
Mailing address:
  • Phone: 561-647-2326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHEL VALLADARES
Title or Position: MGR/ADMINISTRATOR
Credential:
Phone: 561-647-2326