MEDICARE: NEW LIFE MEDICAL CENTER LLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1730042169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	5783 BAYSHORE RD STE 114
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33917-3006
Country	:	US
Telephone Number	:	305-427-3257
Fax Number	:	305-427-3257

Provider Business Practice Location Address
First Line	:	5783 BAYSHORE RD STE 114
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33917-3006
Country	:	US
Telephone Number	:	305-427-3257
Fax Number	:	305-427-3257

Authorized Official
Title or Position	:	OWNER
Name	:	RONNY RODRIGUEZ CABRERA
Credential	:
Telephone Number	:	305-427-3257

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “NEW LIFE MEDICAL CENTER LLC ” Practice Location

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