Provider Demographics
NPI:1306699046
Name:RELIFE FOUNDATION
Entity type:Organization
Organization Name:RELIFE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-487-7464
Mailing Address - Street 1:1000 E ATLANTIC BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7487
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2512 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-8009
Practice Address - Country:US
Practice Address - Phone:407-674-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center