Integrative Physical Medicine

LBN: Park Lake Physical Medicine, Llc
Integrative Physical Medicine is an health care organization with primary practice located at 2206 E Colonial Dr , Orlando FL 32803-4912. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as the primary health care specialty. Park Lake Physical Medicine, Llc can be contacted via phone (407) 839-1045, or through Reid, Shelby Anne via phone (407) 839-1045.

Contact Information

Primary practice address
2206 E Colonial Dr Orlando FL 32803-4912
Phone: (407) 839-1045
Fax: (407) 839-1044
Website:
Map and Directions
Authorized official contact:
Name: Reid, Shelby Anne
Phone: (407) 839-1045

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X

Profile Details

NPI number 1669749396
LBN Legal business name Park Lake Physical Medicine, Llc
DBA Doing business as Integrative Physical Medicine
Authorized official Reid, Shelby Anne
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2011
Last updated Mar 19th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669749396 NPPES
Florida Other 6694190001 DMERC

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