Provider Demographics
NPI:1831796051
Name:COMPLETE MEDICAL MANAGEMENT, LLC.
Entity type:Organization
Organization Name:COMPLETE MEDICAL MANAGEMENT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-606-0337
Mailing Address - Street 1:4960 SW 72ND AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5550
Mailing Address - Country:US
Mailing Address - Phone:305-223-0068
Mailing Address - Fax:305-466-9543
Practice Address - Street 1:4960 SW 72ND AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5550
Practice Address - Country:US
Practice Address - Phone:305-223-0068
Practice Address - Fax:305-466-9543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty