Organization Name: | COMPREHENSIVE CARE OF BROWARD, INC. |
NPI Number: | 1063653079 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYUBOV PAK (PRESIDENT) |
Mailing Address: | 212 Ne 1st Ave Hallandale Beach |
State: | FL US |
Postal Code: | 330094230 |
Phone Number: | 9544548880 |
Fax Number: | 9544541594 |
NPI Enumeration Date: | 03/20/2009 |
NPI Last Update Date: | 03/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | OS 8239 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |