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General NPI Number Information
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NPI Number | 1851968291
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Entity Type | Organization
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Legal Business Name | LIFELONG CARE CORP
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 259 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013
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Country | US
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Telephone | 305-918-2021
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Fax | 786-677-8444
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Provider Business Mailing Address
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Address Line | 259 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1854
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Country | US
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Telephone | 786-776-2021
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Fax | 786-776-2022
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Authorized Official
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Title or Position | FNP / OWNER
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Name | MR. ROSBEL MIRABAL RODRIGUEZ
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Credential | APRN
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Telephone | 786-238-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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