LIFE LINE MEDICAL GROUP INC NPI 1174122337

NPI Information

NPI: 1174122337
Provider Name: LIFE LINE MEDICAL GROUP INC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
12595 SW 137TH AVE STE 206
MIAMI, FL
ZIP 33186
Phone: (786) 474-0541
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LIFE LINE MEDICAL GROUP INC is a general practice in Miami, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LIFE LINE MEDICAL GROUP INC NPI is 1174122337. The provider is registered as an organization entity type.

The provider's business location address is:

12595 SW 137TH AVE STE 206
MIAMI, FL
ZIP 33186-221
Phone: (786) 474-0541

The provider's authorized official is Eulogio Emiliano Benitez .
The authorized official title is President and has the following contact phone number (786) 474-0541.

The enumeration date for this NPI number is 10/20/2020 and was last updated on 10/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	208D00000X	General Practice				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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