Healthcare Provider Details

I. General information

NPI: 1841961679
Provider Name (Legal Business Name): INTEGRATIVE METHODS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
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 Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LILIANA DIETSCH-VAZQUEZ
Title or Position: CEO
Credential:
Phone: 786-774-7729