Provider Demographics
NPI:1447761218
Name:AVISS MEDICAL AND REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:AVISS MEDICAL AND REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-755-2314
Mailing Address - Street 1:17255 SW 95TH AVE APT 119
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4461
Mailing Address - Country:US
Mailing Address - Phone:305-755-2314
Mailing Address - Fax:
Practice Address - Street 1:14351 DELEON STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:FT. MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3390
Practice Address - Country:US
Practice Address - Phone:305-755-2314
Practice Address - Fax:305-755-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty