| Integrated Healthcare Technologies Llc | |
|
580 55th Ave Ne St Petersburg FL 33703-2502 | |
| (813) 380-4990 | |
| Not Available |
| Full Name | Integrated Healthcare Technologies Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 580 55th Ave Ne, St Petersburg, Florida |
| Authorized Official Name and Position | Robert Cash (CEO) |
| Authorized Official Contact | 8133804990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Healthcare Technologies Llc 580 55th Ave Ne St Petersburg FL 33703-2502 Ph: () - | Integrated Healthcare Technologies Llc 580 55th Ave Ne St Petersburg FL 33703-2502 Ph: (813) 380-4990 |
| NPI Number | 1609626233 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 4688116726 |
|---|---|
| Medicare Enrollment ID | O20240605000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609626233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Fabian Alexandro Consbruck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740764158 PECOS PAC ID: 5193158095 Enrollment ID: I20191206002230 |
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