Provider Demographics
NPI:1477591311
Name:NEW LIFE HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:NEW LIFE HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT / BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-229-0040
Mailing Address - Street 1:13155 SW 42ND ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3428
Mailing Address - Country:US
Mailing Address - Phone:305-229-0040
Mailing Address - Fax:305-229-0085
Practice Address - Street 1:13155 SW 42ND ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3428
Practice Address - Country:US
Practice Address - Phone:305-229-0040
Practice Address - Fax:305-229-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108234Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER