Healthcare Provider Details

I. General information

NPI: 1609233378
Provider Name (Legal Business Name): NEW BIRTH NEW LIFE MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 N CONGRESS AVE SUITE 303
WEST PALM BEACH FL
33407-3282
US

IV. Provider business mailing address

4700 N CONGRESS AVE SUITE 303
WEST PALM BEACH FL
33407-3282
US

V. Phone/Fax

Practice location:
  • Phone: 561-691-2031
  • Fax:
Mailing address:
  • Phone: 561-691-2031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MALACHI A LOVE-ROBINSON
Title or Position: OWNER
Credential: ND, PHD, HHP-C, AMP
Phone: 561-480-4506