MEDICARE: COMPREHENSIVE FAMILY MEDICINE, 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
1	207Q00000X	Family Medicine Physician	ME118237	FL

General Provider Information

NPI Number	:	1841606548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE FAMILY MEDICINE, LLC

Provider Business Mailing Address
First Line	:	1016 BRAEMAR DR
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-5013
Country	:	US
Telephone Number	:	205-746-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 BRAEMAR DR
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-5013
Country	:	US
Telephone Number	:	205-746-0070
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JAIME GOBER
Credential	:	M.D.
Telephone Number	:	205-746-0070

Provider Enumeration Date	:	07/02/2014
Last Update Date	:	07/02/2014

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