Provider Demographics
NPI:1801184551
Name:COMFORT HEALTH GROUP LLC.
Entity Type:Organization
Organization Name:COMFORT HEALTH GROUP LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-547-2382
Mailing Address - Street 1:8300 W FLAGLER ST STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-6002
Mailing Address - Country:US
Mailing Address - Phone:786-547-2382
Mailing Address - Fax:305-630-8858
Practice Address - Street 1:5190 NW 167TH ST
Practice Address - Street 2:SUITE #108 & 109
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33014-6328
Practice Address - Country:US
Practice Address - Phone:786-547-2382
Practice Address - Fax:305-630-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization