Healthcare Provider Details

I. General information

NPI: 1477531044
Provider Name (Legal Business Name): NEW LIFE HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 SW 72ND ST STE 108
MIAMI FL
33173-4670
US

IV. Provider business mailing address

9835 SW 72ND ST STE 108
MIAMI FL
33173-4670
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-3549
  • Fax: 305-271-3257
Mailing address:
  • Phone: 305-271-3549
  • Fax: 305-271-3257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number686772
License Number StateFL

VIII. Authorized Official

Name: AMNIA MARTINEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-271-3549