Provider Demographics
NPI:1699110734
Name:NEW LIFE HEALTH CENTER GROUP, INC
Entity type:Organization
Organization Name:NEW LIFE HEALTH CENTER GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORELKY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-715-9818
Mailing Address - Street 1:8045 NW 36TH ST
Mailing Address - Street 2:SUITE 535
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6627
Mailing Address - Country:US
Mailing Address - Phone:305-715-9818
Mailing Address - Fax:305-715-9889
Practice Address - Street 1:8045 NW 36TH ST
Practice Address - Street 2:SUITE 535
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6627
Practice Address - Country:US
Practice Address - Phone:305-715-9818
Practice Address - Fax:305-715-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9751261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation