Healthcare Provider Details

I. General information

NPI: 1013097237
Provider Name (Legal Business Name): COMPREHENSIVE BREAST CENTER LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 SW 87TH CT SUITE 102
MIAMI FL
33176-2315
US

IV. Provider business mailing address

PO BOX 160608
MIAMI FL
33116-0608
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-8394
  • Fax: 305-675-3627
Mailing address:
  • Phone: 305-279-7275
  • Fax: 786-219-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License NumberHCC10405
License Number StateFL

VIII. Authorized Official

Name: ALVARO GARCIA VILLEGAS
Title or Position: CEO
Credential:
Phone: 305-279-7275