Provider Demographics
NPI:1710152285
Name:ADVANCEDTREATMENTCENTER,INC.
Entity Type:Organization
Organization Name:ADVANCEDTREATMENTCENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PIBOON
Authorized Official - Middle Name:
Authorized Official - Last Name:KITIRATANASUMPUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-412-3225
Mailing Address - Street 1:1106 34TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-5432
Mailing Address - Country:US
Mailing Address - Phone:727-388-3796
Mailing Address - Fax:727-388-6888
Practice Address - Street 1:1106 34TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-5432
Practice Address - Country:US
Practice Address - Phone:727-388-3796
Practice Address - Fax:727-388-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No344600000XTransportation ServicesTaxi