Provider Demographics
NPI:1053681924
Name:INSTITUTE FOR HEALTH CARE, LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER FOR MDMR-TRUMED ED, INC
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-951-7404
Mailing Address - Street 1:20 E MELBOURNE AVE
Mailing Address - Street 2:104
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5970
Mailing Address - Country:US
Mailing Address - Phone:321-951-7404
Mailing Address - Fax:321-723-8527
Practice Address - Street 1:930 S HARBOR CITY BLVD
Practice Address - Street 2:100
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1963
Practice Address - Country:US
Practice Address - Phone:321-951-7404
Practice Address - Fax:321-723-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL604211207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty