Basic Information
| Provider Information | |||||||||
| NPI: | 1316037633 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMPREHENSIVE HOME HEALTH CARE, INC. | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | OPUSCARE OF SOUTH FLORIDA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6900 SW 80TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055911606 | ||||||||
| FaxNumber: | 3055911618 | ||||||||
| Practice Location | |||||||||
| Address1: | 6900 SW 80TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055911606 | ||||||||
| FaxNumber: | 3055911618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2006 | ||||||||
| LastUpdateDate: | 09/28/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | TAMAYO | ||||||||
| AuthorizedOfficialFirstName: | JULIO | ||||||||
| AuthorizedOfficialMiddleName: | HUMBERTO | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR/COMPLIANCE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3055911606 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | LHCRM. | ||||||||
| NPICertificationDate: | 09/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 251G00000X | 5013096 | FL | Y | Agencies | Hospice Care, Community Based |
ID Information
| ID | Type | State | Issuer | Description | 150001500 | 05 | FL | MEDICAID |