Provider Demographics
NPI:1366704587
Name:TOTAL LIFE HEALTH CENTER LLC
Entity type:Organization
Organization Name:TOTAL LIFE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-899-4514
Mailing Address - Street 1:10261 SW 72ND ST
Mailing Address - Street 2:SUITE C105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3023
Mailing Address - Country:US
Mailing Address - Phone:786-899-4514
Mailing Address - Fax:786-241-8794
Practice Address - Street 1:10261 SW 72ND ST
Practice Address - Street 2:SUITE C105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3023
Practice Address - Country:US
Practice Address - Phone:786-899-4514
Practice Address - Fax:786-241-8794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty