Provider Demographics
NPI:1306413356
Name:ADVOCATEMD OPERATIONS, LLC
Entity Type:Organization
Organization Name:ADVOCATEMD OPERATIONS, LLC
Other - Org Name:ADVOCATEMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PENNIE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:678-777-7784
Mailing Address - Street 1:417 COMMERCIAL CT STE C&D
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1655
Mailing Address - Country:US
Mailing Address - Phone:941-220-0300
Mailing Address - Fax:941-220-0400
Practice Address - Street 1:417 COMMERCIAL CT STE C&D
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1655
Practice Address - Country:US
Practice Address - Phone:941-220-0300
Practice Address - Fax:941-220-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty