Provider Demographics
NPI:1770180093
Name:AVILA HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:AVILA HEALTH SOLUTIONS
Other - Org Name:AVILA HEALTH SOLUTIONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:TCM SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-765-8414
Mailing Address - Street 1:23503 SW 113TH PASS
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7151
Mailing Address - Country:US
Mailing Address - Phone:786-765-8414
Mailing Address - Fax:
Practice Address - Street 1:8323 NW 12TH ST STE 206
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1840
Practice Address - Country:US
Practice Address - Phone:305-373-3424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management