Provider Demographics
NPI:1437508165
Name:LONG LIFE MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:LONG LIFE MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AURELIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-409-5318
Mailing Address - Street 1:3939 NW 7TH ST
Mailing Address - Street 2:SUITE#206 B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5552
Mailing Address - Country:US
Mailing Address - Phone:786-409-5318
Mailing Address - Fax:786-483-8128
Practice Address - Street 1:3939 NW 7TH ST
Practice Address - Street 2:SUITE#206 B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5552
Practice Address - Country:US
Practice Address - Phone:786-409-5318
Practice Address - Fax:786-483-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service