Provider Demographics
NPI:1598362410
Name:THE I.V. MEDICS, LLC
Entity Type:Organization
Organization Name:THE I.V. MEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HAINES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:601-448-9675
Mailing Address - Street 1:10196 STOREY GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-0086
Mailing Address - Country:US
Mailing Address - Phone:254-291-0809
Mailing Address - Fax:
Practice Address - Street 1:111 N ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2381
Practice Address - Country:US
Practice Address - Phone:601-448-9675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-04
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty