Provider Demographics
NPI:1922244482
Name:INTEGRATED HEALTH SOLUTIONS, PL
Entity Type:Organization
Organization Name:INTEGRATED HEALTH SOLUTIONS, PL
Other - Org Name:D/B/A ADVANCED SPINAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAJETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-701-2225
Mailing Address - Street 1:3628 HARDEN BLVD.
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803
Mailing Address - Country:US
Mailing Address - Phone:863-701-2225
Mailing Address - Fax:863-701-2221
Practice Address - Street 1:3628 HARDEN BLVD.
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803
Practice Address - Country:US
Practice Address - Phone:863-701-2225
Practice Address - Fax:863-701-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11437044OtherCAQH
FL78018OtherBC/BS
FL78018OtherBC/BS