Provider Demographics
NPI:1396636726
Name:I&N MAX GROUP LLC
Entity type:Organization
Organization Name:I&N MAX GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-561-5984
Mailing Address - Street 1:9835 LAKE WORTH RD STE 16127
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2300
Mailing Address - Country:US
Mailing Address - Phone:305-561-5984
Mailing Address - Fax:
Practice Address - Street 1:9835 LAKE WORTH RD STE 16127
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2300
Practice Address - Country:US
Practice Address - Phone:305-561-5984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty