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Organization
MINDFUL INTEGRATED MEDICINE LLC
Active
Organization
MINDFUL INTEGRATED MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVETTE A CHARNECO (OFFICE ADMINISTRATOR)
(407) 846-0533
Entity
Organization
Contact information
Practice address
711 E OAK ST, KISSIMMEE, FL 34744-4573
(407) 846-0533
(407) 518-1730
Mailing address
719 E OAK ST, KISSIMMEE, FL 34744-4580
(407) 846-0533
(407) 518-1730
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
04/27/2016
Last updated
10/04/2016
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