Provider Demographics
NPI:1467891176
Name:INTEGRATIVE HEALTH INSTITUTE LLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SKELLCHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-756-9405
Mailing Address - Street 1:6100 GLADES RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4325
Mailing Address - Country:US
Mailing Address - Phone:561-756-9405
Mailing Address - Fax:561-206-0967
Practice Address - Street 1:6100 GLADES RD
Practice Address - Street 2:SUITE 310
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4325
Practice Address - Country:US
Practice Address - Phone:561-756-9405
Practice Address - Fax:561-206-0967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL88323261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF12914Medicare UPIN