Provider Demographics
NPI:1518230788
Name:NEW LIFE MEDICAL & REHAB CENTER, INC
Entity Type:Organization
Organization Name:NEW LIFE MEDICAL & REHAB CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISUR
Authorized Official - Middle Name:
Authorized Official - Last Name:VEITIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-266-1251
Mailing Address - Street 1:8080 W FLAGLER ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8080 W FLAGLER ST STE 2A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2100
Practice Address - Country:US
Practice Address - Phone:305-266-1251
Practice Address - Fax:305-266-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8509261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service