Healthcare Provider Details

I. General information

NPI: 1194966275
Provider Name (Legal Business Name): ABSOLUTE INTEGRATED MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 17TH ST SUITE P
VERO BEACH FL
32960-5670
US

IV. Provider business mailing address

333 17TH ST SUITE P
VERO BEACH FL
32960-5670
US

V. Phone/Fax

Practice location:
  • Phone: 772-770-6184
  • Fax: 772-770-6310
Mailing address:
  • Phone: 772-770-6184
  • Fax: 772-770-6310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS7615
License Number StateFL

VIII. Authorized Official

Name: DR. DOMINICK JEROME BURO
Title or Position: OWNER/DOCTOR
Credential: D.O.
Phone: 772-770-6184