# INTEGRATIVE MEDICAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407524572
- **Authorized official:** DR. MARVIN ISHMEAL COHEN APRN (OWNER)
- **Authorized official phone:** (352) 284-6774

## Contact information

- **Practice address:** 104 BLUE GROTTO DR, FORT PIERCE, FL 34945-3315
- **Practice address phone:** (352) 284-6774
- **Mailing address:** 104 BLUE GROTTO DR, FORT PIERCE, FL 34945-3315
- **Mailing address phone:** (352) 284-6774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2021
- **Last updated:** 09/02/2021