Provider Demographics
NPI:1629091699
Name:ADVANCED THERAPEUTICS AND HEALTH CARE INC
Entity Type:Organization
Organization Name:ADVANCED THERAPEUTICS AND HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OFFICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:IVY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-721-9201
Mailing Address - Street 1:PO BOX 670884
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-0884
Mailing Address - Country:US
Mailing Address - Phone:954-721-9201
Mailing Address - Fax:954-721-1551
Practice Address - Street 1:7301 N UNIVERSITY DR
Practice Address - Street 2:STE 301
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2919
Practice Address - Country:US
Practice Address - Phone:954-721-9201
Practice Address - Fax:954-721-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07980AMedicare ID - Type Unspecified