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General NPI Number Information
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NPI Number | 1710114483
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Entity Type | Organization
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Legal Business Name | NEW LIFE OB/GYN, LLC
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 7150 W 20TH AVE SUITE 615
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City | HIALEAH
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State | FL
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Zip | 33016-5529
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Country | US
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Telephone | 305-822-3044
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Fax | 305-817-8309
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Provider Business Mailing Address
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Address Line | 7150 W 20TH AVE SUITE 615
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City | HIALEAH
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State | FL
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Zip | 33016-5529
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Country | US
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Telephone | 305-822-3044
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Fax | 305-817-8309
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Authorized Official
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Title or Position | OWNER
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Name | DR. HUGO FERRARA
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Credential | M.D.
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Telephone | 305-822-3044
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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 | ME52907
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License Number State | FL
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