Provider Demographics
NPI:1851629133
Name:INSPIRATIONAL INNOVATIONS, INC.
Entity type:Organization
Organization Name:INSPIRATIONAL INNOVATIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:AUGUSTUS
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:941-412-4070
Mailing Address - Street 1:2532 ONEIDA RD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-3230
Mailing Address - Country:US
Mailing Address - Phone:941-412-4070
Mailing Address - Fax:941-412-4072
Practice Address - Street 1:400 TAMIAMI TRL S
Practice Address - Street 2:#160
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2614
Practice Address - Country:US
Practice Address - Phone:941-412-4070
Practice Address - Fax:941-412-4072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSPIRATIONAL INNOVATIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1179251E00000X
FL231370251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health