Provider Demographics
NPI:1033468830
Name:ADVANTACARE MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:ADVANTACARE MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:386-248-0107
Mailing Address - Street 1:697 MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6821
Mailing Address - Country:US
Mailing Address - Phone:407-539-2111
Mailing Address - Fax:407-539-1211
Practice Address - Street 1:1040 MASON AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4612
Practice Address - Country:US
Practice Address - Phone:386-248-0107
Practice Address - Fax:386-248-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97134208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty