Provider Demographics
NPI:1821287129
Name:COMPREHENSIVE FAMILY MEDICAL PROVIDERS
Entity Type:Organization
Organization Name:COMPREHENSIVE FAMILY MEDICAL PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVORY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:CHRISTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-832-2100
Mailing Address - Street 1:170 S BARFIELD HWY
Mailing Address - Street 2:STE 103
Mailing Address - City:PAHOKEE
Mailing Address - State:FL
Mailing Address - Zip Code:33476-1868
Mailing Address - Country:US
Mailing Address - Phone:561-832-2100
Mailing Address - Fax:
Practice Address - Street 1:170 S BARFIELD HWY
Practice Address - Street 2:STE 103
Practice Address - City:PAHOKEE
Practice Address - State:FL
Practice Address - Zip Code:33476-1868
Practice Address - Country:US
Practice Address - Phone:561-832-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty