Provider Demographics
NPI:1265968754
Name:COMPREHENSIVE VASCULAR CARE PA
Entity type:Organization
Organization Name:COMPREHENSIVE VASCULAR CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-432-4218
Mailing Address - Street 1:8485 BIRD RD STE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3262
Mailing Address - Country:US
Mailing Address - Phone:305-432-4218
Mailing Address - Fax:305-432-4219
Practice Address - Street 1:8485 BIRD RD STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3262
Practice Address - Country:US
Practice Address - Phone:305-432-4218
Practice Address - Fax:888-714-0425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0000X, 261QH0100X
FLME120798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty