Provider Demographics
NPI:1649203837
Name:INTEGRATIVE PEDIATRICS, INC.
Entity Type:Organization
Organization Name:INTEGRATIVE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-359-1770
Mailing Address - Street 1:30 WINDSORMERE WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765
Mailing Address - Country:US
Mailing Address - Phone:407-359-1770
Mailing Address - Fax:
Practice Address - Street 1:30 WINDSORMERE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765
Practice Address - Country:US
Practice Address - Phone:407-359-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7858208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL698811Medicare UPIN