Provider Demographics
NPI:1407158421
Name:INTEGRATED PHYSICIANS CENTERS, LLC.
Entity Type:Organization
Organization Name:INTEGRATED PHYSICIANS CENTERS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DRAESEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:305-383-7585
Mailing Address - Street 1:9010 SW 137TH AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1413
Mailing Address - Country:US
Mailing Address - Phone:305-383-7585
Mailing Address - Fax:305-383-7546
Practice Address - Street 1:9010 SW 137TH AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1413
Practice Address - Country:US
Practice Address - Phone:305-383-7585
Practice Address - Fax:305-383-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty