Provider Demographics
NPI:1588445258
Name:DIAZGARCIA NEWLIFE MEDIHOSPITALGROUP INC
Entity type:Organization
Organization Name:DIAZGARCIA NEWLIFE MEDIHOSPITALGROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-768-0009
Mailing Address - Street 1:10619 W 33RD CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2116
Mailing Address - Country:US
Mailing Address - Phone:786-768-0009
Mailing Address - Fax:
Practice Address - Street 1:14001 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1561
Practice Address - Country:US
Practice Address - Phone:786-609-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty