Provider Demographics
NPI:1598718611
Name:INTEGRATED HEALTH CENTERS OF AMERICA INC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH CENTERS OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-281-0538
Mailing Address - Street 1:5804 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-4366
Mailing Address - Country:US
Mailing Address - Phone:407-281-0538
Mailing Address - Fax:407-273-1848
Practice Address - Street 1:5804 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-4366
Practice Address - Country:US
Practice Address - Phone:407-281-0538
Practice Address - Fax:407-273-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274064800Medicaid
FLK0543Medicare ID - Type UnspecifiedGRUOP MEDICARE NUMBER