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General NPI Number Information
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NPI Number | 1568069441
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Entity Type | Organization
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Legal Business Name | INTEGRATED COMPREHENSIVE URGENT CARE, LLC.
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 3595 W 20TH AVE STE 130
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City | HIALEAH
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State | FL
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Zip | 33012-4537
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Country | US
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Telephone | 786-850-4282
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Fax | 305-598-8796
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Provider Business Mailing Address
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Address Line | 780 NW 42ND AVE STE S301
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City | MIAMI
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State | FL
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Zip | 33126-5540
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Country | US
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Telephone | 786-875-4282
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Fax | 305-317-6130
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILFRED BRACERAS
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Credential |
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Telephone | 786-850-4282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology 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 | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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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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