Healthcare Provider Details

I. General information

NPI: 1487379954
Provider Name (Legal Business Name): INTEGRAL ELITECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7269 SPRING HILL DR
SPRING HILL FL
34606-5066
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 101
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 352-691-5040
  • Fax: 352-691-5042
Mailing address:
  • Phone: 352-799-0046
  • Fax: 352-799-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN P HAYES
Title or Position: CFO
Credential:
Phone: 352-799-0046