| Tricoche Integrated Health Inc | |
|
1855 W Hibiscus Blvd Melbourne FL 32901-2622 | |
| (321) 802-4521 | |
| Not Available |
| Full Name | Tricoche Integrated Health Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1855 W Hibiscus Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Kristen Leigh Laurella (AM) |
| Authorized Official Contact | 3218024521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tricoche Integrated Health Inc 1855 W Hibiscus Blvd Melbourne FL 32901-2622 Ph: (321) 802-4521 | Tricoche Integrated Health Inc 1855 W Hibiscus Blvd Melbourne FL 32901-2622 Ph: (321) 802-4521 |
| NPI Number | 1649896804 |
|---|---|
| Provider Enumeration Date | 06/23/2020 |
| Last Update Date | 12/09/2020 |
| Medicare PECOS PAC ID | 0941625412 |
|---|---|
| Medicare Enrollment ID | O20200730002153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649896804 | NPI | - | NPPES |
| APRN9303071 | Other | FL | STATE OF FLORIDA DEPARTMENT OF HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Debra A Kulchycki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669771960 PECOS PAC ID: 7517115660 Enrollment ID: I20120913000634 |
| Provider Name | Kavita M Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447757265 PECOS PAC ID: 6103180849 Enrollment ID: I20180507000256 |
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