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General NPI Number Information
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NPI Number | 1801293626
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Entity Type | Organization
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Legal Business Name | INTUITIVE NETWORKING
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 110 E GRANADA BLVD SUITE 202
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City | ORMOND BEACH
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State | FL
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Zip | 32176-6603
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Country | US
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Telephone | 386-256-1492
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Fax | 386-753-3622
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Provider Business Mailing Address
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Address Line | 110 E GRANADA BLVD SUITE #202
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City | ORMOND BEACH
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State | FL
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Zip | 32176-6603
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Country | US
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Telephone | 386-256-1492
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Fax | 386-753-3622
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Authorized Official
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Title or Position | FOUNDER/BUSINESS DEVELOPMENT MGR
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Name | MR. DARRELL ANTHONY SHELL
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Credential | MBA
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Telephone | 386-453-4807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 010579300
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License Number State | FL
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