Organization
INTEGRATIVE HEALTH OF ORLANDO LLC
Active
Other names
Integrative Physical Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC OTT (PRESIDENT)
(407) 977-3842
Entity
Organization
Contact information
Practice address
425 ALEXANDRIA BLVD, SUITE 1010, OVIEDO, FL 32765-5516
(407) 977-3842
(407) 977-3433
Mailing address
425 ALEXANDRIA BLVD, SUITE 1010, OVIEDO, FL 32765-5516
(407) 977-3842
(407) 977-3433
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS9108
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FR150A
MEDICARE B PTAN
FL
Enumeration date
10/19/2010
Last updated
03/22/2012
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