Provider Demographics
NPI:1760186217
Name:INTEGRATIVE CARE SERVICES FLORIDA LLC
Entity Type:Organization
Organization Name:INTEGRATIVE CARE SERVICES FLORIDA LLC
Other - Org Name:INTEGRATIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-420-5527
Mailing Address - Street 1:PO BOX 35674
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0634
Mailing Address - Country:US
Mailing Address - Phone:469-420-5527
Mailing Address - Fax:
Practice Address - Street 1:17724 HUNTING BOW CIR STE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5382
Practice Address - Country:US
Practice Address - Phone:469-420-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty