1134664220 NPI number — NP INTEGRATIVE HEALTH CARE PLLC

Table of content: (NPI 1134664220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134664220 NPI number — NP INTEGRATIVE HEALTH CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NP INTEGRATIVE HEALTH CARE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134664220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 621
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MYAKKA CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34251-0621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-995-0458
Provider Business Mailing Address Fax Number:
941-761-5696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13045 MJ RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MYAKKA CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34251-5982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-995-0458
Provider Business Practice Location Address Fax Number:
941-761-5696
Provider Enumeration Date:
12/27/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BEEBE
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
860-995-0458

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: ARNP9403992 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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