UPDATING YOUR PROVIDER INFO…PLEASE PRINT OFF THE FORM BELOW AND RETURN…
• Via Fax to 727-345-7680
• Via Email to providerrelations@ihplan.com
• Via Mail to Integrated Health Plan, 4020 Park Street Suite 103, St Petersburg, FL 33709
 

To view your current demographic information, click here to enter the user name and password below to search your profile – click your back button to return to the change form: