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NPI Code Detail

MEDICARE: COMPREHENSIVE HEALTH CENTER, LLC.

MEDICARE: COMPREHENSIVE HEALTH CENTER, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
298881OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1689663205
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE HEALTH CENTER, LLC.
Provider Business Mailing Address
First Line : 650 NW 120TH ST
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33168-2529
Country : US
Telephone Number : 305-688-0811
Fax Number : 305-688-6304
Provider Business Practice Location Address
First Line : 650 NW 120TH ST
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33168-2529
Country : US
Telephone Number : 305-688-0811
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MARY BALLANTINE
Credential :
Telephone Number : 305-688-0811
Provider Enumeration Date : 10/17/2005
Last Update Date : 07/07/2022

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Directions to “COMPREHENSIVE HEALTH CENTER, LLC. ” Practice Location

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