Provider Demographics
NPI:1336635093
Name:INTEGRATIVE MEDICINE, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-248-3876
Mailing Address - Street 1:5330 CHARLIE BROWN LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3234
Mailing Address - Country:US
Mailing Address - Phone:386-248-3876
Mailing Address - Fax:386-248-3877
Practice Address - Street 1:3900 CLARK RD STE L2
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2375
Practice Address - Country:US
Practice Address - Phone:386-248-3876
Practice Address - Fax:386-248-3877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care