Organization
GREAT LIFE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN VIGIL PEREIRA (OWNER)
(786) 857-4952
Entity
Organization
Contact information
Practice address
4355 W 16TH AVE STE 205B, HIALEAH, FL 33012-7668
(786) 353-2732
(786) 353-2739
Mailing address
4355 W 16TH AVE STE 205B, HIALEAH, FL 33012-7668
(786) 353-2732
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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