Provider Demographics
NPI:1821696766
Name:ADVANCED HEALTHCARE INTEGRATION, LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE INTEGRATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LANMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:321-536-0587
Mailing Address - Street 1:3270 SUNTREE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7505
Mailing Address - Country:US
Mailing Address - Phone:321-536-0587
Mailing Address - Fax:833-291-9415
Practice Address - Street 1:3270 SUNTREE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7505
Practice Address - Country:US
Practice Address - Phone:321-622-4877
Practice Address - Fax:833-291-9415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty