Provider Demographics
NPI:1629308713
Name:INNOVATIVE MEDICAL STAFFING SOLUTIONS INC
Entity Type:Organization
Organization Name:INNOVATIVE MEDICAL STAFFING SOLUTIONS INC
Other - Org Name:IMEDSOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-377-0269
Mailing Address - Street 1:100 S ORANGE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3226
Mailing Address - Country:US
Mailing Address - Phone:407-377-0269
Mailing Address - Fax:407-363-7471
Practice Address - Street 1:100 S ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3226
Practice Address - Country:US
Practice Address - Phone:407-377-0269
Practice Address - Fax:407-363-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care