Provider Demographics
NPI:1568642916
Name:ADVANCE THERAPY SYSTEMS, LLC
Entity Type:Organization
Organization Name:ADVANCE THERAPY SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-504-6518
Mailing Address - Street 1:10803 LAKE WYNDS CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10803 LAKE WYNDS CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3238
Practice Address - Country:US
Practice Address - Phone:561-504-6518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10875225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7888Medicare PIN