Provider Demographics
NPI:1790849891
Name:INTEGRA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:INTEGRA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RECHTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-727-0054
Mailing Address - Street 1:201 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1707
Mailing Address - Country:US
Mailing Address - Phone:954-566-9600
Mailing Address - Fax:
Practice Address - Street 1:201 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1707
Practice Address - Country:US
Practice Address - Phone:954-566-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69109Medicare UPIN
FL55541Medicare ID - Type Unspecified