Provider Demographics
NPI:1114565124
Name:COMPCARE MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:COMPCARE MEDICAL CENTER, LLC
Other - Org Name:COMPCARE MEDICAL CENTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-306-3481
Mailing Address - Street 1:2701 W OAKLAND PARK BLVD STE 3701 4/6
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1388
Mailing Address - Country:US
Mailing Address - Phone:954-306-3481
Mailing Address - Fax:445-300-9263
Practice Address - Street 1:2701 W OAKLAND PARK BLVD STE 310 4/6
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1389
Practice Address - Country:US
Practice Address - Phone:954-306-3481
Practice Address - Fax:445-300-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty