Organization Active NPI

Comprehensive Medical & Research Center LLC

  • General Practice Physician
  • Plantation, FL
National Provider Identifier
1447928643
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COMPREHENSIVE MEDICAL & RESEARCH CENTER LLC
Practice address
4101 NW 3Rd CT Ste 11
Plantation, FL 33317-2830
Phone
(954) 368-3529
Fax
(954) 333-2629
NPI assigned
Sep 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew T Tillett
Title
Manager Member
Phone
(561) 714-3912

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4101 NW 3Rd CT Ste 11
Plantation, FL 33317-2830

Mailing address

4101 NW 3Rd CT Ste 11
Plantation, FL 33317-2830
Phone (954) 368-3529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220217002197 FL Part B Supplier - Clinic/Group Practice 4183017072 Receives reassigned benefits from 3 practitioners
Practice locations: Plantation, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2240820Comprehensive Medical & Research Center LLC4101 NW 3Rd CT Suite 11, Plantation, FL 33317Certificate of waiverOct 21, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1447928643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT STE 11",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172830",
            "telephone_number": "954-368-3529",
            "fax_number": "954-333-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT STE 11",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172830",
            "telephone_number": "954-368-3529",
            "fax_number": "954-333-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE MEDICAL & RESEARCH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "TILLETT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "561-714-3912"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.