Healthcare Provider Details
I. General information
NPI: 1740527571
Provider Name (Legal Business Name): COMFORT MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/14/2013
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
719 NW 29TH ST
MIAMI FL
33127-3828
US
IV. Provider business mailing address
719 NW 29TH ST
MIAMI FL
33127-3828
US
V. Phone/Fax
- Phone: 305-603-8200
- Fax: 305-603-8461
- Phone: 305-603-8200
- Fax: 305-603-8461
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EPHRAIN
CABAN
JR.
Title or Position: MGRM
Credential: M.D.
Phone: 305-603-8200