Provider Demographics
NPI:1851836951
Name:ADVANCE THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:ADVANCE THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARROTE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-456-9484
Mailing Address - Street 1:8000 W FLAGLER ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2157
Mailing Address - Country:US
Mailing Address - Phone:305-456-9484
Mailing Address - Fax:305-456-9484
Practice Address - Street 1:8000 W FLAGLER ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2157
Practice Address - Country:US
Practice Address - Phone:305-456-9484
Practice Address - Fax:305-456-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023956300Medicaid