Provider Demographics
NPI:1376142901
Name:INTERNATIONAL HEALTH AWARENESS CENTER INC
Entity Type:Organization
Organization Name:INTERNATIONAL HEALTH AWARENESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATANT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-209-4120
Mailing Address - Street 1:1921 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-7924
Mailing Address - Country:US
Mailing Address - Phone:239-209-4120
Mailing Address - Fax:239-204-4327
Practice Address - Street 1:1921 GROVE AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7924
Practice Address - Country:US
Practice Address - Phone:239-209-4120
Practice Address - Fax:239-204-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty