Provider Demographics
NPI:1548837560
Name:INFUUSE LLC
Entity type:Organization
Organization Name:INFUUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FETTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-242-4277
Mailing Address - Street 1:8231 EAGLES PARK DR N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-7008
Mailing Address - Country:US
Mailing Address - Phone:571-242-4277
Mailing Address - Fax:917-591-9556
Practice Address - Street 1:8231 EAGLES PARK DR N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-7008
Practice Address - Country:US
Practice Address - Phone:571-242-4277
Practice Address - Fax:917-591-9556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care