Provider Demographics
NPI:1144510462
Name:INSTITUTE FOR HEALTH CARE, LLC
Entity type:Organization
Organization Name:INSTITUTE FOR HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER FOR MGMR-TRUMED ED, INC
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-951-7404
Mailing Address - Street 1:20 E MELBOURNE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5970
Mailing Address - Country:US
Mailing Address - Phone:321-951-7404
Mailing Address - Fax:321-723-8527
Practice Address - Street 1:20 E MELBOURNE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5970
Practice Address - Country:US
Practice Address - Phone:321-951-7404
Practice Address - Fax:321-723-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL604211305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service