Healthcare Provider Details

I. General information

NPI: 1376989137
Provider Name (Legal Business Name): COMPREHENSIVE HEALTHCARE ALLIANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 NW 241ST ST
NEWBERRY FL
32669-2249
US

IV. Provider business mailing address

282 NW 241ST ST
NEWBERRY FL
32669-2249
US

V. Phone/Fax

Practice location:
  • Phone: 352-474-1375
  • Fax: 866-262-3058
Mailing address:
  • Phone: 352-474-1375
  • Fax: 866-262-3058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3295302
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT 12665
License Number StateFL

VIII. Authorized Official

Name: ERIKA LYNNE BARNES
Title or Position: OWNER - CFO
Credential:
Phone: 352-474-1375