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General NPI Number Information
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NPI Number | 1003498163
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTHPROMOTION
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 118 W STATE ROAD 434
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-2551
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Country | US
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Telephone | 914-340-3084
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 ORTEGA ST
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4807
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Country | US
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Telephone | 914-340-3084
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATYA VICTORIA RIDORE
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Credential | FNP
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Telephone | 914-340-3084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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