Organization
INTEGRATIVE FUNCTIONAL MEDICINE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS GASPAR MADURO MD (OWNER)
(786) 945-5440
Entity
Organization
Contact information
Practice address
901 BROOKSIDE DR APT 105, LANSING, MI 48917-8210
(786) 945-5440
Mailing address
901 BROOKSIDE DR APT 105, LANSING, MI 48917-8210
(786) 945-5440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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