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General NPI Number Information
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NPI Number | 1497825244
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Entity Type | Organization
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Legal Business Name | INTEGRATED MEDICAL DIRECTION
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 1 COUNTRY RD E
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City | VILLAGE OF GOLF
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State | FL
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Zip | 33436-5611
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Country | US
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Telephone | 561-272-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 1 COUNTRY RD E
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City | VILLAGE OF GOLF
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State | FL
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Zip | 33436-5611
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Country | US
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Telephone | 561-272-5007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW DAVID LADNER
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Credential | MD
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Telephone | 561-272-5007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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