Integrated Specialty Alliance LLC
Preferred Provider Organization in Miami Lakes, FL. Organization (NPI-2).
NPI number1548035322
StatusActive
Last updated in NPPESOct 18, 2025
Details
- NPI
- 1548035322
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Specialty Alliance LLC
- Organization subpart
- No
- Enumeration date
- Nov 21, 2023
- Certification date
- Oct 18, 2025
- Last updated
- Oct 18, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | – | – | Yes |
Practice location
14400 Nw 77th Ct Ste 306Miami Lakes, FL 33016-1592
Phone 770-810-3796 · Fax 770-810-3789
Mailing address
14400 Nw 77th Ct Ste 301Miami Lakes, FL 33016-1592
Phone 770-810-3796 · Fax 770-810-3789
Authorized official
Debbie Shumake
Coo
7708103796
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