Provider Demographics
NPI:1477568228
Name:COMPLETE HEALTH NETWORK INC.
Entity Type:Organization
Organization Name:COMPLETE HEALTH NETWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSUTIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-7963
Mailing Address - Street 1:12905 SW 42 STREET SUITE 222
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-805-7963
Mailing Address - Fax:305-805-7964
Practice Address - Street 1:12905 SW 42 STREET SUITE 222
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-805-7963
Practice Address - Fax:305-805-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991637251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299991637Medicare ID - Type UnspecifiedSTATE OF FLORIDA LICENSE
FL108074BSMedicare ID - Type UnspecifiedMEDICARE CERTIFIED HHA
FL108074Medicare Oscar/Certification