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Organization
INTEGRATED PRIMARY CARE & PSYCH MENTAL HEALTH LLC
Active
Organization
INTEGRATED PRIMARY CARE & PSYCH MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAS EMANUEL AQUINO-MUNOZ (CHIEF EXECUTIVE OFFICER)
(954) 667-4186
Entity
Organization
Contact information
Practice address
4300 N UNIVERSITY DR STE C103, SUNRISE, FL 33351-6243
(954) 478-5763
(954) 901-2713
Mailing address
4300 N UNIVERSITY DR STE C103, SUNRISE, FL 33351-6243
(954) 478-5763
(954) 901-2713
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/19/2020
Last updated
08/10/2021
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