Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Integrative Physical Medicine of Lake Mary LLC

Organization Specialist · NPI 1043637861

Integrative Physical Medicine of Lake Mary LLC provides Specialist services in Lake Mary, Florida. Registered with an NPI since 2014.

In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1343 S International Pkwy
Lake Mary, FL 32746-1401 Not confirmed with CMS for 10 years — call before visiting
Phone: (407) 792-0705
Fax: (407) 792-0710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1043637861
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationIntegrative Physical Medicine Holding LLC
Authorized official Marc Ott — President · (407) 792-0705
NPI enumeratedMarch 19, 2014
Last updated in NPPESJune 1, 2016
Mailing address1343 S International Pkwy, Lake Mary, FL 32746-1401

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