Provider Demographics
NPI:1326241738
Name:ADVANCED HEALTHCARE ALTERNATIVES, INC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE ALTERNATIVES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCREYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-849-2277
Mailing Address - Street 1:5404 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2503
Mailing Address - Country:US
Mailing Address - Phone:727-849-2277
Mailing Address - Fax:727-597-4789
Practice Address - Street 1:5404 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2503
Practice Address - Country:US
Practice Address - Phone:727-849-2277
Practice Address - Fax:727-597-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5540261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC5540OtherHEALTHCARE CLINIC LICENSE
FLMM11889OtherMASSAGE ESTABLISHMENT LIC
FLK0525Medicare ID - Type UnspecifiedGROUP NUMBER