Provider Demographics
NPI:1083950638
Name:ADVANCED PRACTICE ELDER CARE, LLC
Entity Type:Organization
Organization Name:ADVANCED PRACTICE ELDER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GODAR-MOLLICA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-246-1862
Mailing Address - Street 1:63 COLONY RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469
Mailing Address - Country:US
Mailing Address - Phone:561-246-1862
Mailing Address - Fax:
Practice Address - Street 1:63 COLONY RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33469-3507
Practice Address - Country:US
Practice Address - Phone:561-246-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty