Provider Demographics
NPI: | 1154035848 |
---|---|
Name: | COMPREHENSIVE HEALTH X7 LLC |
Entity type: | Organization |
Organization Name: | COMPREHENSIVE HEALTH X7 LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MEDICAL DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | RYAN |
Authorized Official - Middle Name: | JOHN |
Authorized Official - Last Name: | NAUGHTIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 813-466-8704 |
Mailing Address - Street 1: | 1236 E LAKE COLONY DR |
Mailing Address - Street 2: | |
Mailing Address - City: | MAITLAND |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32751-6124 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3056 UNIVERSITY PKWY |
Practice Address - Street 2: | |
Practice Address - City: | SARASOTA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34243-2502 |
Practice Address - Country: | US |
Practice Address - Phone: | 941-706-4164 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-01-09 |
Last Update Date: | 2023-01-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 111N00000X | Chiropractic Providers | Chiropractor | Group - Multi-Specialty |