Provider Demographics
NPI:1821475922
Name:PRACTICE HEALTH PARTNERSHIPS IPA, INC.
Entity Type:Organization
Organization Name:PRACTICE HEALTH PARTNERSHIPS IPA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-252-9485
Mailing Address - Street 1:9780 E INDIGO ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5609
Mailing Address - Country:US
Mailing Address - Phone:305-252-9485
Mailing Address - Fax:
Practice Address - Street 1:271 CADMAN PLZ E UNIT 25824
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11202-8282
Practice Address - Country:US
Practice Address - Phone:305-252-9485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty