Provider Demographics
NPI:1619511755
Name:ANDI'S INTEGRATED HEALTH CARE,LLC
Entity Type:Organization
Organization Name:ANDI'S INTEGRATED HEALTH CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRINER-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP,FNP-C,PMHNP-C
Authorized Official - Phone:561-339-2534
Mailing Address - Street 1:5345 SE FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8406
Mailing Address - Country:US
Mailing Address - Phone:561-386-2612
Mailing Address - Fax:
Practice Address - Street 1:1801 SE HILLMOOR DR STE C103C104
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7553
Practice Address - Country:US
Practice Address - Phone:772-742-2111
Practice Address - Fax:772-210-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty