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General NPI Number Information
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NPI Number | 1487611844
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Entity Type | Organization
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Legal Business Name | NEW LIFE MEDICAL INSTITUTE INC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 861 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33130-3703
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Country | US
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Telephone | 305-857-9800
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Fax | 305-857-9802
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Provider Business Mailing Address
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Address Line | 861 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33130-3703
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Country | US
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Telephone | 305-857-9800
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Fax | 305-857-9802
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE MICHAILOS
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Credential |
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Telephone | 305-857-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME51394
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME28831
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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