Provider Demographics
NPI:1275000762
Name:ADVANCED CARE OF SOUTH FLORIDA LLC
Entity Type:Organization
Organization Name:ADVANCED CARE OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-974-2878
Mailing Address - Street 1:99 NW 183RD ST STE 239
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4502
Mailing Address - Country:US
Mailing Address - Phone:305-974-2878
Mailing Address - Fax:305-974-2877
Practice Address - Street 1:99 NW 183RD ST STE 239
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-4502
Practice Address - Country:US
Practice Address - Phone:305-974-2878
Practice Address - Fax:305-974-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care