| Organization Name: | INTEGRATIVE MEDICAL GROUP, USA, LLC |
| NPI Number: | 1144628439 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AYLIN OZDEMIR (OWNER) |
| Mailing Address: | 1102 A1a North Suite 104 Ponte Vedra Beach |
| State: | FL US |
| Postal Code: | 32082 |
| Phone Number: | 9042736533 |
| Fax Number: | 9042736532 |
| NPI Enumeration Date: | 12/18/2014 |
| NPI Last Update Date: | 12/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |