Provider Demographics
NPI:1063188589
Name:NEW LIFE FAMILY MEDICINE
Entity type:Organization
Organization Name:NEW LIFE FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERIMELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-677-1475
Mailing Address - Street 1:1011 HORTON ROAD
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2527
Mailing Address - Country:US
Mailing Address - Phone:256-677-1475
Mailing Address - Fax:
Practice Address - Street 1:1011 HORTON ROAD
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2527
Practice Address - Country:US
Practice Address - Phone:256-677-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty