| Organization Name: | ESSENTIAL INTEGRATIVE MEDICINE LLC |
| NPI Number: | 1134470255 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAN THANG TRAN (PRESIDENT) |
| Mailing Address: | 3715 W Azeele St Tampa |
| State: | FL US |
| Postal Code: | 336092807 |
| Phone Number: | 8132530711 |
| Fax Number: | 8132530411 |
| NPI Enumeration Date: | 09/28/2012 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME 84580 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |