INTEGRATED MEDICAL GROUP INCORPORATED (NPI# 1578782132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578782132 |
| Entity Type | Organization |
| Organization Name | INTEGRATED MEDICAL GROUP INCORPORATED |
| Practice Address |
2401 Grand Blvd Holiday FL 34690-4508 |
| Practice Telephone | 7279345757 |
| Practice Fax Number | 7279376258 |
| Mailing Telephone | 7279345757 |
| Mailing Fax Number | 7279376258 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2010-09-08 |
| Authorized Official Name | DAVID HUBER (PROVIDER OWNER) |
| Authorized Official Telephone | 7279345757 |
| Authorized Official Credential | D C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH2603 | FL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STAYWELL GROUP ID | 176018 | 01 |
| FL | AVMED GROUP ID | 280679 | 01 |
| FL | BLUE CROSS GROUP PROVIDER | 55738 | 01 |
| FL | 381250200 | 05 | |
| FL | AMERIGROUP GROUP ID | 235001 | 01 |
| Street Address |
2401 GRAND BLVD |
| City | HOLIDAY |
| State | FL |
| Zip Code | 34690-4508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235125428 | David Huber | Chiropractor | 2401 Grand Blvd, Holiday, FL 34690-4508 | 2005-09-22 |
| 1295946556 | Gregory D Castleman | Chiropractor | 2401 Grand Blvd, Holiday, FL 34690-4508 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770136012 | Peter Steven Bertuccio Jr. | Behavior Technician | 5129 Sandlewood Dr, Holiday, FL 34690 | 2019-07-16 |
| 1699210088 | Lacie Wanner | Massage Therapist | 5331 Whipporwill Dr., Holiday, FL 34690 | 2016-12-21 |
| 1811063886 | Tarpon Springs Hospital Foundation Inc | Preventive Medicine | 2280 Us Highway 19, Hemh Occupational Health Service, Holiday, FL 34690 | 2006-11-28 |
| 1588739239 | Mark C Mccoy | Dentist | 4916 Mile Stretch Dr, Holiday, FL 34690 | 2006-11-21 |
| 1568436533 | Hsuan Shu Lai | General Practice | 4732 Mile Stretch Dr, Holiday, FL 34690 | 2006-02-15 |
| 1255336889 | David Seaman Lindberg Jr. | Internal Medicine | 5304 Milestretch Drive, Holiday, FL 34690 | 2005-06-20 |
| 1245729573 | Callie Blanco | Nurse Practitioner | 4740 Mile Stretch Dr, Holiday, FL 34690 | 2018-05-02 |
| 1033325527 | Diana Morris | Specialist | 3349 Cantrell St, Holiday, FL 34690-1820 | 2007-05-14 |
| 1457354474 | Shahina Javeed | Internal Medicine | 4904 Moog Rd, Holiday, FL 34690-1857 | 2005-05-23 |
| 1275785776 | Shahina Javeed Md Pa | Internal Medicine | 4904 Moog Rd, Holiday, FL 34690-1857 | 2008-10-15 |
| Find all providers in zip 34690 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043785827 | Mario A Nunez | Chiropractor | 3306 Us Highway 19 Unit B, Holiday, FL 34691-1846 | 2018-10-09 |
| 1376758417 | Randolph Clyde Harding | Chiropractor | 2326 Us Hwy 19, Holiday, FL 34691-3939 | 2007-05-11 |
| 1285757369 | Pasco Alternative Healthcare | Chiropractor | 2216 Us Highway 19, Holiday, FL 34691-4351 | 2007-04-06 |
| 1649223280 | Glenn Paul Riddle | Chiropractor | 4617 Mile Stretch Dr, Holiday, FL 34690-4330 | 2006-05-17 |
| 1376529800 | Cornelius Joseph Mcgeehan | Chiropractor | 4630 Darlington Rd, Holiday, FL 34690-3906 | 2005-12-16 |
| 1235125428 | David Huber | Chiropractor | 2401 Grand Blvd, Holiday, FL 34690-4508 | 2005-09-22 |
| 1831184217 | Michael Vincent Shontz | Chiropractor | 2326 Us Highway 19, Holiday, FL 34691-3939 | 2005-09-13 |
| 1982004537 | Atlas Injury Center Inc | Chiropractor | 1817 Us Highway 19, Holiday, FL 34691-5536 | 2014-09-02 |
| 1972812642 | Old Tarpon Chiropractic Pa | Chiropractor | 4630 Darlington Rd, Holiday, FL 34690-3906 | 2010-09-29 |
| 1669780052 | Riddle Family Chiropractic, Inc. | Chiropractor | 4617 Mile Stretch Dr, Holiday, FL 34690-4330 | 2010-09-20 |
| Find all providers in HOLIDAY | ||||
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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.