Manantial de Vida Nueva Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

HCC8847 Issued in FL

Legal business name

MANANTIAL DE VIDA NUEVA INC

Practice address

13255 SW 137TH Ave
Ste. 100
Miami, FL 33186-5326

Phone

(305) 233-8055

Fax

(786) 573-4677

NPI assigned

May 16, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mariulis Rodriguez

Title

President

Phone

(305) 233-8055

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1174816763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13255 SW 137TH AVE",
            "address_2": "STE. 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865326",
            "telephone_number": "305-233-8055",
            "fax_number": "786-573-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13255 SW 137TH AVE",
            "address_2": "STE. 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865326",
            "telephone_number": "305-233-8055",
            "fax_number": "786-573-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANANTIAL DE VIDA NUEVA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MARIULIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-233-8055"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC8847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.