Provider Demographics
NPI:1063470979
Name:PALMETTO COMPREHENSIVE HEALTH CARE INC.
Entity Type:Organization
Organization Name:PALMETTO COMPREHENSIVE HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ENIMISIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-541-8448
Mailing Address - Street 1:1313 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2301
Mailing Address - Country:US
Mailing Address - Phone:305-541-8448
Mailing Address - Fax:305-541-8565
Practice Address - Street 1:1313 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2301
Practice Address - Country:US
Practice Address - Phone:305-541-8448
Practice Address - Fax:305-541-8565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103254Medicare Oscar/Certification