Provider Demographics
NPI:1326072356
Name:COMPREHENSIVE MEDICAL CARE PA
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAIFENG
Authorized Official - Middle Name:
Authorized Official - Last Name:QIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-638-7801
Mailing Address - Street 1:16244 MILITARY TRL
Mailing Address - Street 2:#140
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6534
Mailing Address - Country:US
Mailing Address - Phone:561-638-7801
Mailing Address - Fax:561-638-6114
Practice Address - Street 1:16244 MILITARY TRL
Practice Address - Street 2:#140
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6534
Practice Address - Country:US
Practice Address - Phone:561-638-7801
Practice Address - Fax:561-638-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G62242Medicare UPIN
FL41994AMedicare ID - Type Unspecified