Organization
FOR LIFE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARA T VENTURA M.A. (P)
(786) 254-7636
Entity
Organization
Contact information
Practice address
4355 W 16TH AVE STE 207A, HIALEAH, FL 33012-7669
(786) 254-7636
(786) 254-7162
Mailing address
4355 W 16TH AVE STE 207A, HIALEAH, FL 33012-7669
(786) 254-7636
(786) 254-7162
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
OS12833
FL
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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