Provider Demographics
NPI:1164199881
Name:COMPTON CARE
Entity Type:Organization
Organization Name:COMPTON CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DC
Authorized Official - Phone:352-391-9467
Mailing Address - Street 1:11974 COUNTY ROAD 101 STE 101
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9339
Mailing Address - Country:US
Mailing Address - Phone:352-391-9467
Mailing Address - Fax:352-391-9468
Practice Address - Street 1:11974 COUNTY ROAD 101 STE 101
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9339
Practice Address - Country:US
Practice Address - Phone:352-391-9467
Practice Address - Fax:352-391-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty