Provider Demographics
NPI:1841686805
Name:NEW LIFE THERAPY CENTER CORP
Entity type:Organization
Organization Name:NEW LIFE THERAPY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-592-5477
Mailing Address - Street 1:3900 NW 79TH AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6549
Mailing Address - Country:US
Mailing Address - Phone:305-592-5477
Mailing Address - Fax:786-534-8717
Practice Address - Street 1:3900 NW 79TH AVE STE 515
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6549
Practice Address - Country:US
Practice Address - Phone:305-592-5477
Practice Address - Fax:786-534-8717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty