Healthcare Provider Details

I. General information

NPI: 1831796051
Provider Name (Legal Business Name): COMPLETE MEDICAL MANAGEMENT, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 COW PEN RD STE 205
MIAMI LAKES FL
33014-7619
US

IV. Provider business mailing address

6600 COW PEN RD STE 205
MIAMI LAKES FL
33014-7619
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-0068
  • Fax: 305-466-9543
Mailing address:
  • Phone: 305-223-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DORA GUTIERREZ
Title or Position: COO
Credential:
Phone: 786-985-3895