Healthcare Provider Details

I. General information

NPI: 1609292259
Provider Name (Legal Business Name): JEFFREY GABRIEL COMPAS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 01/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 SW 62ND AVE
SOUTH MIAMI FL
33143-4701
US

IV. Provider business mailing address

1776 WOODSTEAD CT STE 208
THE WOODLANDS TX
77380-1480
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7500
  • Fax:
Mailing address:
  • Phone: 877-749-7428
  • Fax: 512-628-3314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS13359
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: