Provider Demographics
NPI:1285450262
Name:CITRUS INFUSION AND INJECTION CENTER, INC.
Entity type:Organization
Organization Name:CITRUS INFUSION AND INJECTION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DESIREE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:213-925-6585
Mailing Address - Street 1:906 EDEN DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-5934
Mailing Address - Country:US
Mailing Address - Phone:213-925-6585
Mailing Address - Fax:
Practice Address - Street 1:906 EDEN DR
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-5934
Practice Address - Country:US
Practice Address - Phone:352-503-2442
Practice Address - Fax:352-503-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center