LIFE LINE MEDICAL GROUP INC


Address: 12595 Sw 137th Ave Ste 206, Miami, FL 33186-4221
Phone: 7864740541

LIFE LINE MEDICAL GROUP INC (NPI# 1174122337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174122337
Entity Type Organization
Organization Name LIFE LINE MEDICAL GROUP INC
Practice Address 12595 Sw 137th Ave Ste 206
Miami
FL 33186-4221
Practice Telephone 7864740541
Mailing Telephone 7864740541
Enumeration Date 2020-10-20
Last Update Date 2020-10-20
Authorized Official Name EULOGIO EMILIANO BENITEZ (PRESIDENT)
Authorized Official Telephone 7864740541
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities
Y 208D00000X General Practice Allopathic & Osteopathic Physicians

Office Location

Street Address 12595 SW 137TH AVE STE 206
City MIAMI
State FL
Zip Code 33186-4221

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1114561768 Jami Ferrare Nurse Practitioner 9862 Sw 118th Ave, Miami, FL 33186 2019-11-06
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1922575133 University Health Care West Kendall, Inc. Clinic/Center 13611 Sw 131 Street, Miami, FL 33186 2018-10-25
1245705904 Lamberto Hernandez Registered Nurse 12604 Sw 119th Path, Miami, FL 33186 2018-10-09
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1104447804 Dr Jean Pierre LLC General Practice 5050 Biscayne Blvd, Miami, FL 33137-3203 2020-05-04
1891316105 Jorge Luis Vega Morales General Practice 14760 Sw 66th St, Miami, FL 33193-2039 2020-04-28
1518587203 Premium Healthcare Holdings, Lllp General Practice 2400 Sw 69th Ave, Miami, FL 33155-1706 2020-04-22
1770118416 Guido A.perez, M.d., Inc. General Practice 701 Nw 57th Ave Ste 260, Miami, FL 33126-2083 2020-03-03
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Competitor

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City MIAMI
Zip Code 33186

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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