Provider Demographics
NPI:1295828473
Name:NEW LIFE CARE CENTER
Entity Type:Organization
Organization Name:NEW LIFE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-622-2822
Mailing Address - Street 1:3896 NW 167TH ST.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015
Mailing Address - Country:US
Mailing Address - Phone:305-622-2822
Mailing Address - Fax:
Practice Address - Street 1:3896 NW 167TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33054
Practice Address - Country:US
Practice Address - Phone:305-622-2822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9103461OtherSTATE
K7826Medicare ID - Type UnspecifiedGROUP
FLU2862Medicare ID - Type Unspecified