Provider Demographics
NPI:1275727133
Name:COMPLETE MEDICAL CARE LLC
Entity Type:Organization
Organization Name:COMPLETE MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:NATALIA
Authorized Official - Last Name:LUACES
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:305-649-6378
Mailing Address - Street 1:630 NW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4106
Mailing Address - Country:US
Mailing Address - Phone:305-649-6378
Mailing Address - Fax:305-541-6077
Practice Address - Street 1:630 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4106
Practice Address - Country:US
Practice Address - Phone:305-649-6378
Practice Address - Fax:305-541-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AX439Medicare PIN