Provider Demographics
NPI:1619901675
Name:NEW HOPE SOUTH FLORIDA CORP
Entity Type:Organization
Organization Name:NEW HOPE SOUTH FLORIDA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-587-5088
Mailing Address - Street 1:15190 SW 136TH ST
Mailing Address - Street 2:SUITE # 31
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2604
Mailing Address - Country:US
Mailing Address - Phone:786-587-5088
Mailing Address - Fax:786-587-5088
Practice Address - Street 1:15190 SW 136TH ST
Practice Address - Street 2:SUITE # 31
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2604
Practice Address - Country:US
Practice Address - Phone:786-587-5088
Practice Address - Fax:786-587-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5244261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center