Provider Demographics
NPI:1255306262
Name:MEDLIFE HEALTH CARE, INC.
Entity Type:Organization
Organization Name:MEDLIFE HEALTH CARE, INC.
Other - Org Name:MEDLIFE HEALTH SYSTEMS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-7787
Mailing Address - Street 1:7800 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6523
Mailing Address - Country:US
Mailing Address - Phone:305-267-7787
Mailing Address - Fax:305-267-7838
Practice Address - Street 1:7800 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6523
Practice Address - Country:US
Practice Address - Phone:305-267-7787
Practice Address - Fax:305-267-7838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5275261QM1300X, 261QP2000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Not Answered261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39106AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER