Provider Demographics
NPI:1881104941
Name:GOOD LIFE HEALTH CORP
Entity type:Organization
Organization Name:GOOD LIFE HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-479-4322
Mailing Address - Street 1:330 SW 27TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2957
Mailing Address - Country:US
Mailing Address - Phone:786-482-8616
Mailing Address - Fax:786-482-8617
Practice Address - Street 1:330 SW 27TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2957
Practice Address - Country:US
Practice Address - Phone:786-482-8616
Practice Address - Fax:786-482-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty