Provider Demographics
NPI:1558781187
Name:INTERNAL MEDICINE HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:FRANCHESKA
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-744-8113
Mailing Address - Street 1:12200 MENTA ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7540
Mailing Address - Country:US
Mailing Address - Phone:407-930-0787
Mailing Address - Fax:407-930-0788
Practice Address - Street 1:12200 MENTA ST
Practice Address - Street 2:SUITE 107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7540
Practice Address - Country:US
Practice Address - Phone:407-930-0787
Practice Address - Fax:407-930-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102307261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care