Provider Demographics
NPI:1184894479
Name:NEW IMAGE HEALTH CENTER INC
Entity type:Organization
Organization Name:NEW IMAGE HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-244-2546
Mailing Address - Street 1:10041 PINES BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6170
Mailing Address - Country:US
Mailing Address - Phone:954-450-6616
Mailing Address - Fax:954-450-6601
Practice Address - Street 1:8506 SW 8TH ST STE 246
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4053
Practice Address - Country:US
Practice Address - Phone:305-244-2546
Practice Address - Fax:305-262-5637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty