Healthcare Provider Details

I. General information

NPI: 1831486414
Provider Name (Legal Business Name): NEW LIFE PHYSICAL THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 07/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 SW 8TH ST STE 35
MIAMI FL
33174-2900
US

IV. Provider business mailing address

9600 SW 8TH ST STE 35
MIAMI FL
33174-2900
US

V. Phone/Fax

Practice location:
  • Phone: 786-320-0743
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberMA59040
License Number StateFL

VIII. Authorized Official

Name: DAFNE HUMBERTO SANCHEZ
Title or Position: LMT
Credential:
Phone: 786-320-0743