Provider Demographics
NPI:1740283720
Name:COMPREHENSIVE BREAST CARE CENTERS
Entity type:Organization
Organization Name:COMPREHENSIVE BREAST CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:OKSEMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-944-3132
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR
Mailing Address - Street 2:STE 105
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4708
Mailing Address - Country:US
Mailing Address - Phone:305-944-3132
Mailing Address - Fax:305-944-3437
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:STE 105
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4708
Practice Address - Country:US
Practice Address - Phone:305-944-3132
Practice Address - Fax:305-944-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3568228261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography