Provider Demographics
NPI:1285908087
Name:COMPLEX CLINICAL MANAGEMENT, INC
Entity type:Organization
Organization Name:COMPLEX CLINICAL MANAGEMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-994-6000
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2946
Mailing Address - Country:US
Mailing Address - Phone:866-448-7716
Mailing Address - Fax:
Practice Address - Street 1:700 W HILLSBORO BLVD
Practice Address - Street 2:BUILDING 1, SUITE 203
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1609
Practice Address - Country:US
Practice Address - Phone:866-448-7716
Practice Address - Fax:954-843-7307
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIORBRIDGE FAMILY COMPANIES (FL), INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-27
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty