MEDICARE: INNOVATIVE NURSING MANAGEMENT, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH 13650	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1078042	OTHER	FL	NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508932732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE NURSING MANAGEMENT, INC

Provider Business Mailing Address
First Line	:	499 E CENTRAL PKWY
Second Line	:	SUITE 100
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3402
Country	:	US
Telephone Number	:	407-647-4895
Fax Number	:	407-647-5580

Provider Business Practice Location Address
First Line	:	499 E CENTRAL PKWY
Second Line	:	SUITE 100
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3402
Country	:	US
Telephone Number	:	407-647-4895
Fax Number	:	407-647-5580

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN VOLOSIN
Credential	:
Telephone Number	:	407-647-4895

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/10/2011

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