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General NPI Number Information
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NPI Number | 1548384100
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MEDICINE CENTER
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9371 CYPRESS LAKE DR STE 13
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City | FORT MYERS
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State | FL
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Zip | 33919-4995
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Country | US
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Telephone | 239-274-3413
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Fax | 239-415-8661
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Provider Business Mailing Address
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Address Line | 9371 CYPRESS LAKE DR
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City | FORT MYERS
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State | FL
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Zip | 33919-4939
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Country | US
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Telephone | 239-274-3413
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Fax | 239-415-8661
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LIDIA OKONSKI
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Credential | M.D
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Telephone | 239-274-3413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 001033 AP
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | ME 36300
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License Number State | FL
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