SUMMIT INTEGRATIVE HEALTH, LLC (NPI# 1295202984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295202984 |
| Entity Type | Organization |
| Organization Name | SUMMIT INTEGRATIVE HEALTH, LLC |
| Practice Address |
12627 San Jose Blvd Ste 305 Jacksonville FL 32223-8639 |
| Practice Telephone | 9046834376 |
| Practice Fax Number | 9046834378 |
| Mailing Telephone | 9046834376 |
| Mailing Fax Number | 9046834378 |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |
| Authorized Official Name | DR. JUSTIN TINKER (OWNER) |
| Authorized Official Telephone | 4044059168 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
12627 SAN JOSE BLVD STE 305 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-8639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1528680220 | Florida Injury & Regenerative Medicine, Pllc | General Practice | 8640 Philips Hwy Ste 10, Jacksonville, FL 32256-1208 | 2020-05-15 |
| 1689296808 | Sajid Khan Md LLC | General Practice | 4600 Touchton Rd E Ste 1150, Jacksonville, FL 32246-1542 | 2020-05-11 |
| 1396392767 | Yurelsy Galvez Ricardo | General Practice | 725 Middle Branch Way, Jacksonville, FL 32259-6201 | 2019-08-21 |
| 1639721772 | Deborah Brabham | General Practice | 10990 Lydia Estates Dr E, Jacksonville, FL 32218-6940 | 2019-07-09 |
| 1851868459 | Nursing On Demand Inc | General Practice | 1260 Mcduff Ave S # 3, Jacksonville, FL 32205-8030 | 2018-11-01 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1255859641 | Mcgowan Medical Centers, Pa | General Practice | 3021 N Main St, Jacksonville, FL 32206-2122 | 2017-09-06 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1700247863 | Emily Calhoun | General Practice | 554 Kelly Ln, Jacksonville, FL 32234-3049 | 2016-03-16 |
| 1023402054 | Matthew Joesph Lash | General Practice | Naval Medical Center, 100 Brewster Blvd., Camp Lejeune, Jacksonville, NC 28547-2538 | 2015-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
Please comment or provide details below to improve the information on SUMMIT INTEGRATIVE HEALTH, LLC.
| 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.