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General NPI Number Information
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NPI Number | 1467851576
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Entity Type | Organization
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Legal Business Name | CARE OF LIFE MEDICAL SERVICE CORP.
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 2140 W FLAGLER ST STE 209A
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City | MIAMI
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State | FL
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Zip | 33135-1642
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Country | US
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Telephone | 305-644-2626
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Fax | 305-541-1736
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Provider Business Mailing Address
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Address Line | 2140 W FLAGLER ST STE 209A
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City | MIAMI
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State | FL
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Zip | 33135-1642
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Country | US
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Telephone | 305-644-2626
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Fax | 305-541-1736
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BARBARA GONZALEZ
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Credential | MA
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Telephone | 305-644-2626
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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 | MA 67461
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License Number State | FL
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