Provider Demographics
NPI:1477335602
Name:AVANT GUARD INFUSIONS LLC
Entity Type:Organization
Organization Name:AVANT GUARD INFUSIONS LLC
Other - Org Name:AVANT GUARD INFUSIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES-CARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:732-503-9678
Mailing Address - Street 1:717 WOODCHUCK LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-2161
Mailing Address - Country:US
Mailing Address - Phone:732-300-7806
Mailing Address - Fax:
Practice Address - Street 1:717 WOODCHUCK LN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-2161
Practice Address - Country:US
Practice Address - Phone:732-300-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion