Provider Demographics
NPI:1437540648
Name:ADVANCE HEALTHCARE ALLIANCE, INC.
Entity Type:Organization
Organization Name:ADVANCE HEALTHCARE ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-966-7575
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0127
Mailing Address - Country:US
Mailing Address - Phone:787-966-7575
Mailing Address - Fax:787-966-7577
Practice Address - Street 1:1995 CARR. 2
Practice Address - Street 2:TORRE A SUITE 1001 METRO MEDICAL CENTER
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-966-7575
Practice Address - Fax:787-966-7577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty