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Organization
INTEGRATED MEDICAL GROUP INCORPORATED
Active
Organization
INTEGRATED MEDICAL GROUP INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HUBER D C (PROVIDER OWNER)
(727) 934-5757
Entity
Organization
Contact information
Practice address
2401 GRAND BLVD, HOLIDAY, FL 34690-4508
(727) 934-5757
(727) 937-6258
Mailing address
2401 GRAND BLVD, HOLIDAY, FL 34690-4508
(727) 934-5757
(727) 937-6258
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH2603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176018
STAYWELL GROUP ID
FL
01
—
235001
AMERIGROUP GROUP ID
FL
01
—
280679
AVMED GROUP ID
FL
05
—
381250200
—
FL
01
—
55738
BLUE CROSS GROUP PROVIDER
FL
Enumeration date
04/24/2007
Last updated
09/08/2010
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