Healthcare Provider Details

I. General information

NPI: 1851389308
Provider Name (Legal Business Name): COMPREHENSIVE CANCER CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4306 ALTON RD
MIAMI BEACH FL
33140-2840
US

IV. Provider business mailing address

4306 ALTON RD
MIAMI BEACH FL
33140-2840
US

V. Phone/Fax

Practice location:
  • Phone: 305-535-3300
  • Fax: 305-535-3356
Mailing address:
  • Phone: 305-535-3300
  • Fax: 305-535-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG COVINGTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 305-535-3322