| Comprehensive Health Center, Llc. | |
|
650 Nw 120th St North Miami FL 33168-2529 | |
| (305) 688-0811 | |
| Not Available |
| Full Name | Comprehensive Health Center, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 650 Nw 120th St, North Miami, Florida |
| Authorized Official Name and Position | Mary Ballantine (OFFICE MANAGER) |
| Authorized Official Contact | 3056880811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Health Center, Llc. 650 Nw 120th St North Miami FL 33168-2529 Ph: (305) 688-0811 | Comprehensive Health Center, Llc. 650 Nw 120th St North Miami FL 33168-2529 Ph: (305) 688-0811 |
| NPI Number | 1689663205 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 07/07/2022 |
| Medicare PECOS PAC ID | 3971521584 |
|---|---|
| Medicare Enrollment ID | O20051102000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689663205 | NPI | - | NPPES |
| 060722301 | Medicaid | FL | |
| 98881 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rudolph Moise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366431983 PECOS PAC ID: 3577581180 Enrollment ID: I20110803000270 |
| Provider Name | Natalie Beauregard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740672534 PECOS PAC ID: 5991002867 Enrollment ID: I20160322000407 |
| Provider Name | Jean Claude Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235683822 PECOS PAC ID: 5799045332 Enrollment ID: I20180131000137 |
| Provider Name | Bethel Laine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528463387 PECOS PAC ID: 1153635925 Enrollment ID: I20200406002708 |
| Provider Name | Willy Clerisier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518478650 PECOS PAC ID: 5890115869 Enrollment ID: I20201013000273 |
| Provider Name | Faith Finoli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184119216 PECOS PAC ID: 7911302484 Enrollment ID: I20210820001887 |
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