Provider Demographics
NPI:1366682619
Name:INTEGRATED SERVICES OF SOUTH FLORIDA, INC.
Entity Type:Organization
Organization Name:INTEGRATED SERVICES OF SOUTH FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-695-3996
Mailing Address - Street 1:1898 W HILLSBORO BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1434
Mailing Address - Country:US
Mailing Address - Phone:954-571-9392
Mailing Address - Fax:954-571-6788
Practice Address - Street 1:1898 W HILLSBORO BLVD STE H
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1434
Practice Address - Country:US
Practice Address - Phone:954-571-9392
Practice Address - Fax:954-571-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5536261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty