Provider Demographics
NPI:1619596517
Name:INTEEM HEALTH
Entity Type:Organization
Organization Name:INTEEM HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHORT-RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, SFNP
Authorized Official - Phone:863-529-6899
Mailing Address - Street 1:PO BOX 690316
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0316
Mailing Address - Country:US
Mailing Address - Phone:863-458-0579
Mailing Address - Fax:
Practice Address - Street 1:11977 S APOPKA VINELAND RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-7025
Practice Address - Country:US
Practice Address - Phone:863-458-0579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute CareGroup - Multi-Specialty