Provider Demographics
NPI:1104792019
Name:NEW LIFE REHAB & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:NEW LIFE REHAB & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-647-2326
Mailing Address - Street 1:3750 W 16TH AVE STE 140U
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4662
Mailing Address - Country:US
Mailing Address - Phone:561-647-2326
Mailing Address - Fax:
Practice Address - Street 1:3750 W 16TH AVE STE 140U
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4662
Practice Address - Country:US
Practice Address - Phone:561-647-2326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy