Provider Demographics
NPI:1609233378
Name:NEW BIRTH NEW LIFE MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:NEW BIRTH NEW LIFE MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALACHI
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOVE-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND, PHD, HHP-C, AMP
Authorized Official - Phone:561-480-4506
Mailing Address - Street 1:4700 N CONGRESS AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3282
Mailing Address - Country:US
Mailing Address - Phone:561-691-2031
Mailing Address - Fax:
Practice Address - Street 1:4700 N CONGRESS AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3282
Practice Address - Country:US
Practice Address - Phone:561-691-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty