OrganizationActive
Individualized Medicine, LLC
NPI 1962701722 · Primary Care Clinic/Center · Palatka, FL
Provider details
- NPI number
- 1962701722
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Larisa Malykh, Practice Owner/Physician(386) 329-3939
Specialties & taxonomies
Ambulatory Health Care Facilities
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
6100 Saint Johns Ave
Suite 4(d)
Palatka, FL 32177-3844
Phone: (386) 329-3939
Fax: (386) 329-8990
Street-level locationGet directions
Mailing address
Po Box 100
Elkton, FL 32033-0100
Registry dates
- Enumerated
- 2011-03-19
- Last updated
- 2012-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.