Provider Demographics
NPI:1376661868
Name:INTEGRAL ORTHOPEDICS INC
Entity Type:Organization
Organization Name:INTEGRAL ORTHOPEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:TUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-885-0199
Mailing Address - Street 1:302 NW 179TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2818
Mailing Address - Country:US
Mailing Address - Phone:954-885-0199
Mailing Address - Fax:954-885-0399
Practice Address - Street 1:302 NW 179TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2818
Practice Address - Country:US
Practice Address - Phone:954-885-0199
Practice Address - Fax:954-885-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313222332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1313222OtherHME LICENSE NUMBER