Organization
NEW LIFE INFUSION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL IGNACIO TANO M.D. (PRESIDENT)
(305) 649-3260
Entity
Organization
Contact information
Practice address
1455 SW 27TH AVE, MIAMI, FL 33145-1234
(305) 649-3260
(305) 649-3261
Mailing address
1455 SW 27TH AVE, MIAMI, FL 33145-1234
(305) 649-3260
(305) 649-3261
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
170066-0002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044443000
—
FL
Enumeration date
02/14/2007
Last updated
06/25/2008
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