Provider Demographics
| NPI: | 1154097962 |
|---|---|
| Name: | ADVANTAGE HEALTH CENTER LLC |
| Entity Type: | Organization |
| Organization Name: | ADVANTAGE HEALTH CENTER LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ARCILIO |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ALVARADO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 787-690-9018 |
| Mailing Address - Street 1: | PO BOX 16804 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SAN JUAN |
| Mailing Address - State: | PR |
| Mailing Address - Zip Code: | 00908-6804 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 888-400-0073 |
| Mailing Address - Fax: | 787-289-8715 |
| Practice Address - Street 1: | 15 LUIS MUNOZ RIVERA AVE |
| Practice Address - Street 2: | PASEO CARIBE, SUITE 1060 |
| Practice Address - City: | SAN JUAN |
| Practice Address - State: | PR |
| Practice Address - Zip Code: | 00901 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 888-900-0073 |
| Practice Address - Fax: | 787-289-8715 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-08-20 |
| Last Update Date: | 2021-11-24 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
| No | 174400000X | Other Service Providers | Specialist | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
