Healthcare Provider Details
I. General information
NPI: 1720154123
Provider Name (Legal Business Name): LIFE CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2006
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 W 41ST ST
MIAMI BEACH FL
33140-3637
US
IV. Provider business mailing address
300 W 41ST ST
MIAMI BEACH FL
33140-3637
US
V. Phone/Fax
- Phone: 305-674-0911
- Fax: 305-674-0912
- Phone: 305-674-0911
- Fax: 305-674-0912
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | HCC7300 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | HCC7300 |
| License Number State | FL |
VIII. Authorized Official
Name:
JOSE
PARAFITA
Title or Position: OWNER
Credential:
Phone: 786-356-1794