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General NPI Number Information
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NPI Number | 1013313048
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Entity Type | Organization
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Legal Business Name | HEALTH LIFE CENTER INC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 2260 SW 8TH ST SUITE 300
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City | MIAMI
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State | FL
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Zip | 33135-4924
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Country | US
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Telephone | 786-253-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 2260 SW 8TH ST SUITE 300
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City | MIAMI
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State | FL
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Zip | 33135-4924
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Country | US
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Telephone | 786-253-3202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERTO PEREZ LUGO
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Credential | MA
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Telephone | 786-253-3202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME51899
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License Number State | FL
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