Organization
INTEGRATIVE MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN ISHMEAL COHEN APRN (OWNER)
(352) 284-6774
Entity
Organization
Contact information
Practice address
104 BLUE GROTTO DR, FORT PIERCE, FL 34945-3315
(352) 284-6774
Mailing address
104 BLUE GROTTO DR, FORT PIERCE, FL 34945-3315
(352) 284-6774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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