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General NPI Number Information
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NPI Number | 1275281461
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CLINICAL CENTER DBA VITAL HEALTHCARE GROUP
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 10201 HAMMOCKS BLVD STE 122
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City | MIAMI
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State | FL
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Zip | 33196-3783
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Country | US
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Telephone | 786-701-8702
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Fax | 305-397-2669
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Provider Business Mailing Address
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Address Line | 10201 HAMMOCKS BLVD STE 122
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City | MIAMI
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State | FL
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Zip | 33196-3783
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Country | US
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Telephone | 786-701-8702
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Fax | 305-397-2669
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Authorized Official
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Title or Position | CEO
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Name | GREGORIO CONTRERAS RODRIGUEZ
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Credential |
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Telephone | 786-701-8702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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