Healthcare Provider Details

I. General information

NPI: 1568069441
Provider Name (Legal Business Name): INTEGRATED COMPREHENSIVE URGENT CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 W 20TH AVE STE 130
HIALEAH FL
33012-4537
US

IV. Provider business mailing address

780 NW 42ND AVE STE 301
MIAMI FL
33126-5536
US

V. Phone/Fax

Practice location:
  • Phone: 786-850-4282
  • Fax: 305-598-8796
Mailing address:
  • Phone: 786-875-4282
  • Fax: 305-317-6130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH BRACERAS
Title or Position: PRESIDENT
Credential:
Phone: 305-863-8860