Healthcare Provider Details

I. General information

NPI: 1558617324
Provider Name (Legal Business Name): NEW LIFE HEALTH CARE GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 N UNIVERSITY DR SUITES 101 - 102
TAMARAC FL
33321-2128
US

IV. Provider business mailing address

7800 N UNIVERSITY DR SUITES 101 - 102
TAMARAC FL
33321-2128
US

V. Phone/Fax

Practice location:
  • Phone: 954-670-1170
  • Fax: 954-670-1171
Mailing address:
  • Phone: 954-670-1170
  • Fax: 954-670-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: CELAIDA RUIZ
Title or Position: PRESIDENT
Credential:
Phone: 954-670-1170