OrganizationActive
Integrative Physical Medicine of Lake Mary LLC
NPI 1043637861 · Specialist · Lake Mary, FL
Provider details
- NPI number
- 1043637861
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Parent organization
- Integrative Physical Medicine Holding LLC
- Organization subpart
- Yes
- Authorized official
- Marc Ott, President(407) 792-0705
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1343 S International Pkwy
Lake Mary, FL 32746-1401
Phone: (407) 792-0705
Fax: (407) 792-0710
Street-level locationGet directions
Mailing address
1343 S International Pkwy
Lake Mary, FL 32746-1401
Registry dates
- Enumerated
- 2014-03-19
- Last updated
- 2016-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.