Healthcare Provider Details

I. General information

NPI: 1942604939
Provider Name (Legal Business Name): HOPE OF LIFE MEDICAL RESEARCH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SW 27TH AVE 601
MIAMI FL
33135-2961
US

IV. Provider business mailing address

330 SW 27TH AVE 601
MIAMI FL
33135-2961
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-7646
  • Fax:
Mailing address:
  • Phone: 786-536-7646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA G ROQUE
Title or Position: OWNER / PRESIDENT
Credential:
Phone: 786-536-7646