Provider Demographics
NPI:1922257005
Name:NEW LIFE HEALTH CENTER INC
Entity Type:Organization
Organization Name:NEW LIFE HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-245-5536
Mailing Address - Street 1:950 N KROME AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4400
Mailing Address - Country:US
Mailing Address - Phone:305-245-5933
Mailing Address - Fax:
Practice Address - Street 1:950 N KROME AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4400
Practice Address - Country:US
Practice Address - Phone:305-245-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty