For Life Medical Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

OS12833 Issued in FL

Legal business name

FOR LIFE MEDICAL INC

Practice address

4355 W 16TH Ave Ste 207a
Hialeah, FL 33012-7669

Phone

(786) 254-7636

Fax

(786) 254-7162

NPI assigned

Oct 13, 2014

Last updated

Oct 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mara T Ventura, M.A.

Title

P

Phone

(786) 254-7636

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1194129684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 207A",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127669",
            "telephone_number": "786-254-7636",
            "fax_number": "786-254-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 207A",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127669",
            "telephone_number": "786-254-7636",
            "fax_number": "786-254-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOR LIFE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "VENTURA",
        "authorized_official_first_name": "MARA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "P",
        "authorized_official_telephone_number": "786-254-7636",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "OS12833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.