Provider Demographics
NPI:1376724906
Name:ALTERNATIVE MEDICINE INTEGRATION OF FLORIDA
Entity Type:Organization
Organization Name:ALTERNATIVE MEDICINE INTEGRATION OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANGFORD
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:727-826-5281
Mailing Address - Street 1:735 ARLINGTON AVE N
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3652
Mailing Address - Country:US
Mailing Address - Phone:727-826-5281
Mailing Address - Fax:727-826-5066
Practice Address - Street 1:735 ARLINGTON AVE N
Practice Address - Street 2:SUITE 206
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3652
Practice Address - Country:US
Practice Address - Phone:727-826-5281
Practice Address - Fax:727-826-5066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE MEDICNE INTEGRATION GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL912150100Medicaid