Healthcare Provider Details

I. General information

NPI: 1871567289
Provider Name (Legal Business Name): COMPREHENSIVE PATHOLOGY ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 198227
ATLANTA GA
30384-8227
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-4486
  • Fax: 786-596-5986
Mailing address:
  • Phone: 786-596-6525
  • Fax: 786-596-5986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberME35809
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberME35809
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME35809
License Number StateFL

VIII. Authorized Official

Name: EDWIN GOULD
Title or Position: DIRECTOR
Credential: M.D.
Phone: 786-596-6525