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General NPI Number Information
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NPI Number | 1447928643
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL & RESEARCH CENTER LLC
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4101 NW 3RD CT STE 11
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City | PLANTATION
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State | FL
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Zip | 33317-2830
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Country | US
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Telephone | 954-368-3529
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Fax | 954-333-2629
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Provider Business Mailing Address
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Address Line | 4101 NW 3RD CT STE 11
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City | PLANTATION
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State | FL
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Zip | 33317-2830
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Country | US
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Telephone | 954-368-3529
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Fax | 954-333-2629
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Authorized Official
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Title or Position | MANAGER MEMBER
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Name | ANDREW T TILLETT
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Credential |
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Telephone | 561-714-3912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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