Healthcare Provider Details

I. General information

NPI: 1336526664
Provider Name (Legal Business Name): NEW WORLD MEDICAL & THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SW 1ST ST STE 100
MIAMI FL
33135-1603
US

IV. Provider business mailing address

2020 SW 1ST ST
MIAMI FL
33135-1603
US

V. Phone/Fax

Practice location:
  • Phone: 305-541-0109
  • Fax: 786-657-2804
Mailing address:
  • Phone: 305-541-0109
  • Fax: 786-657-2804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberME22082
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: ELIZABERTH SERNA
Title or Position: OPERATGIONS
Credential:
Phone: 702-468-8934