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General NPI Number Information
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NPI Number | 1922257005
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Entity Type | Organization
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Legal Business Name | NEW LIFE HEALTH CENTER INC
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 950 N KROME AVE SUITE 202
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City | HOMESTEAD
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State | FL
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Zip | 33030-4400
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Country | US
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Telephone | 305-245-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 950 N KROME AVE SUITE 202
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City | HOMESTEAD
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State | FL
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Zip | 33030-4400
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Country | US
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Telephone | 305-245-5933
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MYRNA PENA
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Credential |
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Telephone | 305-245-5536
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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 |
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License Number State |
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