Provider Demographics
NPI:1528602661
Name:ADVANCE PRIMARY CARE GROUP LLC
Entity Type:Organization
Organization Name:ADVANCE PRIMARY CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-2840
Mailing Address - Street 1:8910 MIRAMAR PKWY STE 207
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4961
Mailing Address - Country:US
Mailing Address - Phone:954-367-2840
Mailing Address - Fax:954-505-3378
Practice Address - Street 1:8910 MIRAMAR PKWY STE 207
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4961
Practice Address - Country:US
Practice Address - Phone:954-367-2840
Practice Address - Fax:954-505-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service