Provider Demographics
NPI:1548728280
Name:VIP INTEGRATIVE HEALTH CARE LLC
Entity type:Organization
Organization Name:VIP INTEGRATIVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENATUS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-909-8555
Mailing Address - Street 1:3600 FOREST HILL BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5617
Mailing Address - Country:US
Mailing Address - Phone:561-909-8555
Mailing Address - Fax:747-220-0351
Practice Address - Street 1:3600 FOREST HILL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-5617
Practice Address - Country:US
Practice Address - Phone:561-909-8555
Practice Address - Fax:747-220-0351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Multi-Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care HomeGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102753900Medicaid
FLME130639OtherME LICENSE
FL6907096OtherAFCH
FL9274128OtherARNP LICENSE