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Contact Information

INTEGRA CONCIERGE MEDICINE LLC
10175 FORTUNE PKWY UNIT 204
JACKSONVILLE, FL32256-6748
 Phone: 904-619-3609
 Fax: 904-900-2225
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Integrative Medicine

202D00000X
Indicates primary specialty

NPI Profile & details for INTEGRA CONCIERGE MEDICINE LLC · (Female)

NPI # 1992673305
Status Active
Credentials
Entity Individual
Enumeration date 10/27/2025
Last updated 10/27/2025 - About 7 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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