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General NPI Number Information
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NPI Number | 1770042475
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Entity Type | Organization
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Legal Business Name | HEMO LIFE LINE LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 14160 PALMETTO FRNTG RD STE 100
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1641
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Country | US
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Telephone | 786-703-5111
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Fax | 786-703-5157
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Provider Business Mailing Address
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Address Line | 14160 PALMETTO FRNTG RD STE 100
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1641
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Country | US
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Telephone | 786-703-5111
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Fax | 786-703-5157
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FELIX A GARCIA
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Credential |
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Telephone | 786-703-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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