Provider Demographics
NPI:1982452124
Name:FULL LIFE PATIENT CARE LLC
Entity type:Organization
Organization Name:FULL LIFE PATIENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-260-6707
Mailing Address - Street 1:7700 N KENDALL DR STE 300O
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7559
Mailing Address - Country:US
Mailing Address - Phone:305-260-6707
Mailing Address - Fax:786-206-1992
Practice Address - Street 1:7700 N KENDALL DR STE 300O
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7559
Practice Address - Country:US
Practice Address - Phone:305-260-6707
Practice Address - Fax:786-206-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care