Provider Demographics
NPI:1417242942
Name:ADVANCE MEDICAL SERVICE CENTER INC
Entity Type:Organization
Organization Name:ADVANCE MEDICAL SERVICE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:DE FARIMA
Authorized Official - Last Name:PI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-286-4940
Mailing Address - Street 1:5200 SW 8TH ST STE 206B
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2337
Mailing Address - Country:US
Mailing Address - Phone:786-286-4940
Mailing Address - Fax:
Practice Address - Street 1:5200 SW 8TH ST # 206 B
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2300
Practice Address - Country:US
Practice Address - Phone:786-286-4940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service