Provider Demographics
NPI:1336537331
Name:AMERICAN INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:AMERICAN INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-330-3844
Mailing Address - Street 1:1001 S FORT HARRISON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3941
Mailing Address - Country:US
Mailing Address - Phone:727-330-3844
Mailing Address - Fax:888-349-9247
Practice Address - Street 1:1001 S FORT HARRISON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3941
Practice Address - Country:US
Practice Address - Phone:727-330-3844
Practice Address - Fax:888-349-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113826208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty