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General NPI Number Information
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NPI Number | 1427908110
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Entity Type | Organization
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Legal Business Name | INNOVATE HEALTH MEDICAL CLINIC CORP
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 4051 NW 43RD ST STE 33
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City | GAINESVILLE
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State | FL
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Zip | 32606-4579
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Country | US
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Telephone | 786-616-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 4051 NW 43RD ST STE 33
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City | GAINESVILLE
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State | FL
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Zip | 32606-4579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | NOIRALTIH HERRERA
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Credential |
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Telephone | 786-616-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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