INTEGRATIVE PHYSICAL MEDICINE OF MOUNT DORA LLC (NPI# 1104223916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104223916 |
| Entity Type | Organization |
| Organization Name | INTEGRATIVE PHYSICAL MEDICINE OF MOUNT DORA LLC |
| Other Organization Name | INTEGRATIVE PHYSICAL MEDICINE |
| Practice Address |
2818 S Bay St Eustis FL 32726 |
| Mailing Address |
2818 S Bay St Eustis FL 32726-6537 |
| Practice Telephone | 3525612361 |
| Practice Fax Number | 3525612363 |
| Mailing Telephone | 3525612361 |
| Mailing Fax Number | 3525612363 |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2018-09-28 |
| Authorized Official Name | BRET SCHEUPLEIN (OWNER) |
| Authorized Official Telephone | 3525612361 |
| Is Organization Subpart | Y |
| Parent Organization Name | INTEGRATIVE PHYSICAL MEDICINE HOLDING LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Integrative Physical Medicine | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6909 Old Highway 441, Mount Dora, FL 32757 | 3525612361 | 3525612363 |
| Street Address |
2818 S BAY ST |
| City | EUSTIS |
| State | FL |
| Zip Code | 32726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508497637 | Alton Emory Kinlaw | Pharmacist | 99 Hillside Drive, Eustis, FL 32726 | 2020-01-28 |
| 1053833426 | Nalia Elizabeth Alicea | Behavioral Analyst | 949 Marietta Lane, Eustis, FL 32726 | 2017-07-07 |
| 1760840938 | Beautiful Angels LLC | Exclusive Provider Organization | 2208 Virginia Avenue, Eustis, FL 32726 | 2016-02-03 |
| 1902274624 | Breakthrough Transitions LLC | Social Worker | 2201 S. Bay Street, Suite B-2, Eustis, FL 32726 | 2015-09-11 |
| 1154763290 | Irina N Krasilova | Pharmacist | 1950 Sr 19 N, Eustis, FL 32726 | 2013-07-17 |
| 1063773679 | Mangalmurti LLC | Pharmacy | 17435 Us Highway 441, Suite-102, Eustis, FL 32726 | 2012-05-31 |
| 1477813806 | My Darling Angels Home Companion Services | Private Vehicle | 102 Morningview Dr, Eustis, FL 32726 | 2012-05-18 |
| 1801166186 | Akhlaqus Chowdhury | Pharmacist | 2005 North Sr 19, Eustis, FL 32726 | 2012-01-04 |
| 1316269244 | Kamlesh Patel | Pharmacist | 2705 Cotton Ct, Eustis, FL 32726 | 2010-02-19 |
| 1245446616 | Mary Catherine Puhr | Nurse Practitioner | 2300 Kurt St, Eustis, FL 32726 | 2007-05-15 |
| Find all providers in zip 32726 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568789733 | Susan Korem | Specialist | 2105 Prevatt St, Eustis, FL 32726-6131 | 2010-04-28 |
| 1194053611 | Healthy Choice Ob-gyn, P.a. | Specialist | 400 W Woodward Ave, Eustis, FL 32726-4555 | 2009-11-20 |
| 1154503654 | Mid-florida Pulmonary Associates Pa | Specialist | 720 N Bay St Ste 4, Eustis, FL 32726 | 2007-11-27 |
| 1316154180 | Augustus M Davis Jr. | Specialist | 1301 S Bay St, Eustis, FL 32726-5550 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758893 | Ursula Olazabal | Specialist | 402 N Babcock St Ste 101, Melbourne, FL 32935-7335 | 2020-10-18 |
| 1043818529 | Michele Rosenthal | Specialist | 425 Greenwich Circle, #107, Jupiter, FL 33458-4809 | 2020-10-15 |
| 1184230096 | Lauren Daisey Woodruff | Specialist | 4440 Nelson Ave, Sarasota, FL 34231-7515 | 2020-09-17 |
| 1699385823 | Suzanne Denise Moe | Specialist | 48 Nw 4th St, Homestead, FL 33030-5942 | 2020-08-03 |
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1417566712 | Angela Berry Williams | Specialist | 5175 W Atlantic Ave Ste C, Delray Beach, FL 33484-8101 | 2020-07-23 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1316562911 | A School 4 Legends LLC | Specialist | 11565 Se 57th Ct, Belleview, FL 34420-4361 | 2020-06-10 |
| 1700400397 | Juda Mclaren | Specialist | 7360 Beacon Hill Loop Apt 8, Orlando, FL 32818-6431 | 2020-05-30 |
| 1811518384 | Lori Rubin | Specialist | 8181 W Broward Blvd Ste 204, Plantation, FL 33324-2049 | 2020-05-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.