Provider Demographics
NPI:1285222166
Name:LIFE SPRING RESEARCH FOUNDATION
Entity Type:Organization
Organization Name:LIFE SPRING RESEARCH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SITE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-436-4155
Mailing Address - Street 1:432 SW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2507
Mailing Address - Country:US
Mailing Address - Phone:786-409-3785
Mailing Address - Fax:786-409-2253
Practice Address - Street 1:432 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2507
Practice Address - Country:US
Practice Address - Phone:786-409-3785
Practice Address - Fax:786-409-2253
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE SPRING RESEARCH FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty