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General NPI Number Information
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NPI Number | 1760186217
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CARE SERVICES FLORIDA LLC
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 17724 HUNTING BOW CIR STE 101
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City | LUTZ
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State | FL
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Zip | 33558-5382
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Country | US
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Telephone | 469-420-0085
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35674
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City | BELFAST
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State | ME
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Zip | 04915-0634
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Country | US
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Telephone | 469-420-5527
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Fax |
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Authorized Official
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Title or Position | AO
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Name | NESTOR ZENAROSA
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Credential | MD
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Telephone | 469-420-5527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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