# ADVANCED INTEGRATIVE MEDICINE OF TAMPA BAY LLC

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

## Provider details

- **NPI number:** 1578350872
- **Authorized official:** DONNA MALONE DO (OWNER)
- **Authorized official phone:** (904) 338-5442

## Contact information

- **Practice address:** 1806 SHORT BRANCH DR STE 101, TRINITY, FL 34655-4426
- **Practice address phone:** (904) 338-5442
- **Mailing address:** PO BOX 1015, ODESSA, FL 33556-1015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/22/2025
- **Last updated:** 05/05/2025