Provider Demographics
NPI:1629896980
Name:INTEGRATED COMPREHENSIVE URGENT CARE LLC
Entity type:Organization
Organization Name:INTEGRATED COMPREHENSIVE URGENT CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-271-1515
Mailing Address - Street 1:8700 N KENDALL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2206
Mailing Address - Country:US
Mailing Address - Phone:305-271-1515
Mailing Address - Fax:
Practice Address - Street 1:8700 N KENDALL DR STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2206
Practice Address - Country:US
Practice Address - Phone:305-271-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty