Provider Demographics
NPI:1194485276
Name:INTEGRATIVE MEDICINE OF SOUTH FLORIDA, S.CORP
Entity type:Organization
Organization Name:INTEGRATIVE MEDICINE OF SOUTH FLORIDA, S.CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-435-9434
Mailing Address - Street 1:429 COCONUT ISLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2425
Mailing Address - Country:US
Mailing Address - Phone:708-435-9434
Mailing Address - Fax:
Practice Address - Street 1:2810 E OAKLAND PARK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1822
Practice Address - Country:US
Practice Address - Phone:954-248-3294
Practice Address - Fax:954-642-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty