Comprehensive Medical & Research Center Llc | |
150 Nw 70th Ave Ste 10 Plantation FL 33317-2911 | |
(954) 368-3529 | |
(954) 333-2629 |
Full Name | Comprehensive Medical & Research Center Llc |
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Speciality | General Practice |
Location | 150 Nw 70th Ave Ste 10, Plantation, Florida |
Authorized Official Name and Position | Andrew T Tillett (MANAGER MEMBER) |
Authorized Official Contact | 5617143912 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Comprehensive Medical & Research Center Llc 150 Nw 70th Ave Ste 10 Plantation FL 33317-2911 Ph: (954) 368-3529 | Comprehensive Medical & Research Center Llc 150 Nw 70th Ave Ste 10 Plantation FL 33317-2911 Ph: (954) 368-3529 |
NPI Number | 1447928643 |
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Provider Enumeration Date | 09/01/2021 |
Last Update Date | 02/16/2023 |
Medicare PECOS PAC ID | 4183017072 |
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Medicare Enrollment ID | O20220217002197 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447928643 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Grethell Estrada |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750825543 PECOS PAC ID: 4082988274 Enrollment ID: I20170927001963 |
Provider Name | Wilmer R Santiesteban Garcia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437522752 PECOS PAC ID: 2860795606 Enrollment ID: I20180921002565 |
Provider Name | Jyothi Gunta |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679834725 PECOS PAC ID: 2668726605 Enrollment ID: I20181112000186 |
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