Provider Demographics
NPI:1912896549
Name:ALIVE MIAMI LLC
Entity type:Organization
Organization Name:ALIVE MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO BARUQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-315-7354
Mailing Address - Street 1:121 NE 34TH ST UNIT 3002
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3889
Mailing Address - Country:US
Mailing Address - Phone:786-315-7354
Mailing Address - Fax:
Practice Address - Street 1:901 S MIAMI AVE STE 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3043
Practice Address - Country:US
Practice Address - Phone:305-897-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy