Provider Demographics
NPI:1518391747
Name:LIFE AND HEALTH MEDICAL CENTER
Entity Type:Organization
Organization Name:LIFE AND HEALTH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-207-1595
Mailing Address - Street 1:8890 SW 24TH ST STE 214
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2060
Mailing Address - Country:US
Mailing Address - Phone:305-207-1595
Mailing Address - Fax:305-207-1596
Practice Address - Street 1:8890 SW 24TH ST STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2060
Practice Address - Country:US
Practice Address - Phone:305-207-1595
Practice Address - Fax:305-207-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center