Organization
ETERNITY LIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEISY ORTIZ-JORRIN (PRESIDENT)
(786) 257-7423
Entity
Organization
Contact information
Practice address
12311 SW 133RD CT STE 23, MIAMI, FL 33186-6434
(786) 257-7423
Mailing address
12311 SW 133RD CT STE 23, MIAMI, FL 33186-6434
(786) 257-7423
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
09/26/2024
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