# INTEGRATED INDEPENDENT PHYSICIANS NETWORK, LLC

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

## Provider details

- **NPI number:** 1730783556
- **Authorized official:** KATHY MONNETT (EXECUTIVE ASSISTA NT)
- **Authorized official phone:** (407) 475-9213

## Contact information

- **Practice address:** 1101 N LAKE DESTINY RD STE 300, MAITLAND, FL 32751-7121
- **Practice address phone:** (407) 475-9213
- **Practice address fax:** (407) 475-9203
- **Mailing address:** 1101 N LAKE DESTINY RD STE 300, MAITLAND, FL 32751-7121
- **Mailing address phone:** (407) 475-9213
- **Mailing address fax:** (407) 475-9203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/23/2020
- **Last updated:** 11/23/2020