=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013885128
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW WORLD HEALTHCARE CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2025
-----------------------------------------------------
Last Update Date | 01/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5803 NW 151ST ST STE 107
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-355-9063
-----------------------------------------------------
Fax | 786-444-9563
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5803 NW 151ST ST STE 107
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-355-9063
-----------------------------------------------------
Fax | 786-444-9563
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | RANDY FERNANDEZ CANIZARES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-355-9063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------