Provider Demographics
NPI:1063270981
Name:FUNCTIONAL & INTEGRATIVE HEALTH CENTER, LLC
Entity type:Organization
Organization Name:FUNCTIONAL & INTEGRATIVE HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHLUGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, WHNP-BC
Authorized Official - Phone:786-246-5801
Mailing Address - Street 1:16737 NE 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3837
Mailing Address - Country:US
Mailing Address - Phone:786-246-5801
Mailing Address - Fax:786-408-5669
Practice Address - Street 1:3909 NE 163RD ST # 113&113A
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4126
Practice Address - Country:US
Practice Address - Phone:786-246-5801
Practice Address - Fax:786-408-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty