MEDICARE: HEALTH IS LIFE MEDICAL GROUP

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	:	1841930955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH IS LIFE MEDICAL GROUP

Provider Business Mailing Address
First Line	:	13951 SW 184TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-2259
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13951 SW 184TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-2259
Country	:	US
Telephone Number	:	786-368-7289
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANELLY FERRER
Credential	:
Telephone Number	:	786-368-7289

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	03/29/2022

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Directions to “HEALTH IS LIFE MEDICAL GROUP ” Practice Location

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