Integrated Neurosciences of Orlando

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

ME106951 Issued in FL

Legal business name

INTEGRATED NEUROSCIENCES OF ORLANDO

Practice address

7450 Dr Phillips Blvd
Ste 314
Orlando, FL 32819-5119

Phone

(407) 757-2523

Fax

(407) 757-2530

NPI assigned

Jul 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Keda Henderson

Title

Director of Operations

Phone

(772) 713-6290

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1215312947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 DR PHILLIPS BLVD",
            "address_2": "STE 314",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195119",
            "telephone_number": "407-757-2523",
            "fax_number": "407-757-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 DR PHILLIPS BLVD",
            "address_2": "STE 314",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195119",
            "telephone_number": "407-757-2523",
            "fax_number": "407-757-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED NEUROSCIENCES OF ORLANDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "KEDA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "772-713-6290",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "FL",
            "license": "ME106951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integra Neuro Pain Institute PA
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• Integrated Regional Laboratories Pathology Services, LLC
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• Integrated Regional Laboratories Pathology Services, LLC

• Prescribing (Medical) Psychologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Prescribing (Medical) Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.