Provider Demographics
NPI:1659542116
Name:INNOVATIVE HEALTH CARE OPTIONS, LLC
Entity Type:Organization
Organization Name:INNOVATIVE HEALTH CARE OPTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVORY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-455-3301
Mailing Address - Street 1:201 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5524
Mailing Address - Country:US
Mailing Address - Phone:954-455-3301
Mailing Address - Fax:954-455-4435
Practice Address - Street 1:201 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5524
Practice Address - Country:US
Practice Address - Phone:954-455-3301
Practice Address - Fax:954-455-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty