Provider Demographics
NPI:1467216523
Name:COMPLETE MEDICAL HEATHCARE LLC
Entity Type:Organization
Organization Name:COMPLETE MEDICAL HEATHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HEISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-808-0488
Mailing Address - Street 1:735 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-9226
Mailing Address - Country:US
Mailing Address - Phone:386-301-4450
Mailing Address - Fax:386-872-4232
Practice Address - Street 1:735 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9226
Practice Address - Country:US
Practice Address - Phone:386-301-4450
Practice Address - Fax:386-872-4232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty