Provider Demographics
NPI:1649405127
Name:NEW LIFE CLINICAL SERVICES INC
Entity type:Organization
Organization Name:NEW LIFE CLINICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-3950
Mailing Address - Street 1:7811 CORAL WAY
Mailing Address - Street 2:STE # 120
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6540
Mailing Address - Country:US
Mailing Address - Phone:305-267-3950
Mailing Address - Fax:305-267-3949
Practice Address - Street 1:7811 CORAL WAY
Practice Address - Street 2:STE # 120
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6540
Practice Address - Country:US
Practice Address - Phone:305-267-3950
Practice Address - Fax:305-267-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMC1673261QP3300X
FLHCC8453261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain