Basic Information
| Provider Information | |||||||||
| NPI: | 1851551675 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMPREHENSIVE ORTHOPEDICS LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COMPREHENSIVE ORTHOPEDIC GLOBAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11567 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008014567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407792663 | ||||||||
| FaxNumber: | 3407792443 | ||||||||
| Practice Location | |||||||||
| Address1: | 9151 ESTATE THOMAS | ||||||||
| Address2: | SUITE 206 FOOTHILL PROFESSIONAL BLDG. | ||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008022617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407792663 | ||||||||
| FaxNumber: | 3407792443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BACOT | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | CARLOS | ||||||||
| AuthorizedOfficialTitleorPosition: | SURGEON | ||||||||
| AuthorizedOfficialTelephone: | 3407792663 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 1-6918-1L | VI | N | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | 174400000X | VI | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.