Healthcare Provider Details

I. General information

NPI: 1023271434
Provider Name (Legal Business Name): MARTIN LIFE SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 SW 136TH PL
MIAMI FL
33175-1050
US

IV. Provider business mailing address

1717 SW 136TH PL
MIAMI FL
33175-1050
US

V. Phone/Fax

Practice location:
  • Phone: 786-290-8108
  • Fax: 305-226-7210
Mailing address:
  • Phone: 786-290-8108
  • Fax: 305-226-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOSEFA C MARTIN
Title or Position: PRESIDENT
Credential:
Phone: 786-290-8108