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General NPI Number Information
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NPI Number | 1386700912
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Entity Type | Organization
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Legal Business Name | NEW LIFE POLYCLINICS INC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 61 HOOK SQ
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-4401
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Country | US
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Telephone | 305-884-8880
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Fax | 305-884-7740
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Provider Business Mailing Address
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Address Line | 61 HOOK SQ
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-4401
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Country | US
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Telephone | 305-884-8880
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Fax | 305-884-7740
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA TERESA COLUMBIE
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Credential |
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Telephone | 305-884-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HCC7720
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License Number State | FL
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