National Provider Identifier Database

FORMA INTEGRATED HEALTHCARE
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

FORMA INTEGRATED HEALTHCARE
2655 S RAINBOW BLVD STE 410
LAS VEGAS, NV89146-5100
Phone: 702-726-9722
Fax: 702-906-0067
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Family 103TF0000X
Family 363LF0000X
Family Medicine 207Q00000X
Psychiatric/Mental Health 363LP0808X
Wound Care 163WW0000X

* Indicates primary specialty

NPI Profile & details for FORMA INTEGRATED HEALTHCARE

NPI Number 1023964657
Legal business name
LBN
FORMA INTEGRATED HEALTHCARE
Authorized official ANN UGANIZA - (CEO)
Entity Organization
Organization subpart No
Enumeration date 03/06/2026
Last updated 03/09/2026 - About 3 months ago
Sole proprietor1 Not specified
Identifiers n/a

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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