Provider Demographics
NPI:1568220051
Name:IMMUNE INFUSION LLC
Entity Type:Organization
Organization Name:IMMUNE INFUSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RESHMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-658-1323
Mailing Address - Street 1:601 UNIVERSITY BLVD STE 202B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2788
Mailing Address - Country:US
Mailing Address - Phone:561-658-1323
Mailing Address - Fax:561-775-4990
Practice Address - Street 1:601 UNIVERSITY BLVD STE 202B
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2788
Practice Address - Country:US
Practice Address - Phone:561-658-1323
Practice Address - Fax:561-775-4990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy