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General NPI Number Information
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NPI Number | 1053361527
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL CARE CENTER
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 242
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179
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Country | US
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Telephone | 305-949-6700
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Fax | 305-949-6773
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Provider Business Mailing Address
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Address Line | P.O. BOX 327360
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City | FT LAUDERDALE
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State | FL
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Zip | 33332
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Country | US
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Telephone | 305-949-6700
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Fax | 305-949-6773
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Authorized Official
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Title or Position | DIRECTOR
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Name | SERGE VILVAR
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Credential | M.D.
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Telephone | 786-252-2769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME 78304
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License Number State | FL
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