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General NPI Number Information
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NPI Number | 1679972640
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH NP, LLC
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 13841 VALLEYBROOKE LN
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City | ORLANDO
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State | FL
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Zip | 32826-2643
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Country | US
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Telephone | 407-409-2142
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Fax |
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Provider Business Mailing Address
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Address Line | 13841 VALLEYBROOKE LN
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City | ORLANDO
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State | FL
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Zip | 32826-2643
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Country | US
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Telephone | 407-409-2142
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Fax |
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Authorized Official
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Title or Position | ARNP
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Name | RACHEL GROVES
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Credential |
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Telephone | 407-409-2142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9232275
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License Number State | FL
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