Provider Demographics
NPI:1770042475
Name:HEMO LIFE LINE LLC
Entity Type:Organization
Organization Name:HEMO LIFE LINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-703-5111
Mailing Address - Street 1:14160 PALMETTO FRNTG RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1641
Mailing Address - Country:US
Mailing Address - Phone:786-703-5111
Mailing Address - Fax:786-703-5157
Practice Address - Street 1:14160 PALMETTO FRNTG RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1641
Practice Address - Country:US
Practice Address - Phone:786-703-5111
Practice Address - Fax:786-703-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal DialysisGroup - Single Specialty