# LIFESPAN MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427769561
- **Authorized official:** MARIA ESTHER MEDINA (CEO)
- **Authorized official phone:** (786) 252-9131

## Contact information

- **Practice address:** 2742 SW 8TH ST STE 11, MIAMI, FL 33135-4656
- **Practice address phone:** (786) 615-5819
- **Practice address fax:** (786) 615-5953
- **Mailing address:** 2742 SW 8TH ST STE 11, MIAMI, FL 33135-4656
- **Mailing address phone:** (786) 615-5819
- **Mailing address fax:** (786) 615-5953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | — |
| 122300000X | Dentist | — | — | — |
| 152W00000X | Optometrist | — | — | — |
| 163W00000X | Registered Nurse | — | — | — |
| 171100000X | Acupuncturist | — | — | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2022
- **Last updated:** 12/09/2022