NPIMap

Organization Active NPI

Great Life Medical Center, Inc

  • Community/Behavioral Health Agency
  • Hialeah, FL
National Provider Identifier
1790376887
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GREAT LIFE MEDICAL CENTER, INC
Practice address
4355 W 16TH Ave Ste 205B
Hialeah, FL 33012-7668
Phone
(786) 353-2732
Fax
(786) 353-2739
NPI assigned
Feb 1, 2021
Last updated
Feb 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Adrian Vigil PereiraNPI 1073028296
Title
Owner
Phone
(786) 857-4952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

4355 W 16TH Ave Ste 205B
Hialeah, FL 33012-7668

Mailing address

4355 W 16TH Ave Ste 205B
Hialeah, FL 33012-7668
Phone (786) 353-2732

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1790376887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 205B",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127668",
            "telephone_number": "786-353-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 W 16TH AVE STE 205B",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127668",
            "telephone_number": "786-353-2732",
            "fax_number": "786-353-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LIFE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "VIGIL PEREIRA",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-857-4952"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.