# INTEGRATED HEALING CLINIC LLC

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

## Provider details

- **NPI number:** 1477877330
- **Authorized official:** SAMER FADDA AP (OWNER)
- **Authorized official phone:** (813) 402-2832

## Contact information

- **Practice address:** 10549 N FLORIDA AVE, SUITE I, TAMPA, FL 33612-6707
- **Practice address phone:** (813) 402-2832
- **Practice address fax:** (813) 402-2833
- **Mailing address:** 10549 N FLORIDA AVE, SUITE I, TAMPA, FL 33612-6707
- **Mailing address phone:** (813) 402-2832
- **Mailing address fax:** (813) 402-2833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 03/22/2010
- **Last updated:** 02/06/2013