Healthcare Provider Details

I. General information

NPI: 1366393712
Provider Name (Legal Business Name): INTEGRAONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 BELL SHOALS RD
BRANDON FL
33511-8813
US

IV. Provider business mailing address

1108 BELL SHOALS RD
BRANDON FL
33511-8813
US

V. Phone/Fax

Practice location:
  • Phone: 813-359-8787
  • Fax: 813-359-8788
Mailing address:
  • Phone: 813-359-8787
  • Fax: 813-359-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIAS FEANNY
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 305-519-5891