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General NPI Number Information
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NPI Number | 1871615682
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH CENTER
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 13155 SW 42ND STREET SUIT 111 112
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City | MIAMI
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State | FL
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Zip | 33175-3428
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Country | US
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Telephone | 305-559-7063
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Fax | 305-559-7839
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Provider Business Mailing Address
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Address Line | 13155 SW 42ND STREET SUIT 111 112
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City | MIAMI
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State | FL
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Zip | 33175-3428
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Country | US
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Telephone | 305-559-7063
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Fax | 305-559-7839
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Authorized Official
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Title or Position | PEDIATRICIAN MEDICAL DIRECTOR
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Name | ISABEL ALTAGRACIA FERREIRA
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Credential | MD
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Telephone | 305-559-7063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME57254
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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