Provider Demographics
NPI:1124609573
Name:TREE OF LIFE COMMUNITY MEDICAL CENTER INC
Entity type:Organization
Organization Name:TREE OF LIFE COMMUNITY MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOHALYS
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-404-3973
Mailing Address - Street 1:15600 SW 288TH ST STE 305A
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1555
Mailing Address - Country:US
Mailing Address - Phone:786-404-3973
Mailing Address - Fax:
Practice Address - Street 1:15600 SW 288TH ST STE 305A
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1555
Practice Address - Country:US
Practice Address - Phone:786-404-3973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health