Provider Demographics
NPI:1407263833
Name:COMPREHENSIVE HEALTH SPECIALISTS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:772-486-7427
Mailing Address - Street 1:3662 SW 30TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3720
Mailing Address - Country:US
Mailing Address - Phone:772-220-5880
Mailing Address - Fax:772-220-5888
Practice Address - Street 1:3662 SW 30TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3720
Practice Address - Country:US
Practice Address - Phone:772-220-5880
Practice Address - Fax:772-220-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9235485261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty