Provider Demographics
NPI:1083046775
Name:PHILOGENE, IMLINN
Entity Type:Individual
Prefix:MS
First Name:IMLINN
Middle Name:
Last Name:PHILOGENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8865 COMMODITY CIR
Mailing Address - Street 2:UNIT 11, SUITE 201
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9077
Mailing Address - Country:US
Mailing Address - Phone:407-250-6901
Mailing Address - Fax:
Practice Address - Street 1:8865 COMMODITY CIR
Practice Address - Street 2:UNIT 11, SUITE 201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9077
Practice Address - Country:US
Practice Address - Phone:407-250-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator