Provider Demographics
NPI:1326093527
Name:COMPREHENSIVE HEALTHCARE P A
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTHCARE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-443-9924
Mailing Address - Street 1:646 HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-2902
Mailing Address - Country:US
Mailing Address - Phone:321-443-9924
Mailing Address - Fax:800-930-4957
Practice Address - Street 1:575 N CLYDE MORRIS BLVD STE A
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2318
Practice Address - Country:US
Practice Address - Phone:321-355-7377
Practice Address - Fax:800-930-4957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252738300Medicaid
FL252738300Medicaid