Provider Demographics
NPI:1063911998
Name:INTEGRITY PHYSICIANS GROUP LLC
Entity type:Organization
Organization Name:INTEGRITY PHYSICIANS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIESO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-825-0587
Mailing Address - Street 1:2369 W 52ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7210
Mailing Address - Country:US
Mailing Address - Phone:305-825-0587
Mailing Address - Fax:305-825-7136
Practice Address - Street 1:10899 SW 72ND ST STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2722
Practice Address - Country:US
Practice Address - Phone:305-274-5319
Practice Address - Fax:305-274-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization