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General NPI Number Information
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NPI Number | 1407343015
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTHCARE OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 6152 VERDE TRL N
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City | BOCA RATON
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State | FL
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Zip | 33433-2430
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Country | US
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Telephone | 954-388-0900
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Fax | 954-901-2838
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Provider Business Mailing Address
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Address Line | 2098 NE 54TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3158
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Country | US
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Telephone | 954-650-7662
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Fax | 954-901-2838
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Authorized Official
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Title or Position | OWNER/MEDICAL DOCTOR
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Name | DINH PHAM
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Credential | MD
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Telephone | 954-650-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME82117
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License Number State | FL
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