MEDICARE: QUALITY OF LIFE SERVICING CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235697830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY OF LIFE SERVICING CORP

Provider Business Mailing Address
First Line	:	4101 RAVENSWOOD RD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5301
Country	:	US
Telephone Number	:	869-536-7297
Fax Number	:	786-353-2349

Provider Business Practice Location Address
First Line	:	4101 RAVENSWOOD RD STE 205
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5301
Country	:	US
Telephone Number	:	786-953-6729
Fax Number	:	786-353-2349

Authorized Official
Title or Position	:	PRESIDENT AND EXECUTIVE DIRECTOR
Name	:	ARIADNA GONZALEZ BERMUDEZ
Credential	:	CBHCM
Telephone Number	:	786-304-7731

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	07/02/2026

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