Provider Demographics
NPI:1528705084
Name:INTEGRA HEALTH LLC
Entity type:Organization
Organization Name:INTEGRA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YORAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTFREUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-596-9387
Mailing Address - Street 1:4401 ROYAL PALM AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3039
Mailing Address - Country:US
Mailing Address - Phone:917-596-9387
Mailing Address - Fax:
Practice Address - Street 1:4401 ROYAL PALM AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3039
Practice Address - Country:US
Practice Address - Phone:917-596-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty