Healthcare Provider Details

I. General information

NPI: 1992068241
Provider Name (Legal Business Name): INTEGRATIVE METHODS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 NW 208TH WAY
PEMBROKE PINES FL
33029-2154
US

IV. Provider business mailing address

PO BOX 297883
PEMBROKE PINES FL
33029-7883
US

V. Phone/Fax

Practice location:
  • Phone: 786-774-7729
  • Fax: 954-391-8176
Mailing address:
  • Phone: 786-774-7729
  • Fax: 954-391-8176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB 1-08-4716
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 11239
License Number StateFL

VIII. Authorized Official

Name: LILIANA DIETSCH-VAZQUEZ
Title or Position: OWNER
Credential: M.ED., OTR/L, BCBA
Phone: 786-774-7729