Provider Demographics
NPI:1710114483
Name:NEW LIFE OB/GYN, LLC
Entity Type:Organization
Organization Name:NEW LIFE OB/GYN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-822-3044
Mailing Address - Street 1:7150 W 20TH AVE
Mailing Address - Street 2:SUITE 615
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5529
Mailing Address - Country:US
Mailing Address - Phone:305-822-3044
Mailing Address - Fax:305-817-8309
Practice Address - Street 1:7150 W 20TH AVE
Practice Address - Street 2:SUITE 615
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5529
Practice Address - Country:US
Practice Address - Phone:305-822-3044
Practice Address - Fax:305-817-8309
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA WOMEN CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52907261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service