Provider Demographics
NPI:1912185042
Name:ADVANCHED HEALTH & WELLNESS INC
Entity Type:Organization
Organization Name:ADVANCHED HEALTH & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-342-8692
Mailing Address - Street 1:932 SW 82ND AVE
Mailing Address - Street 2:UNIT 7
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:932 SW 82ND AVE
Practice Address - Street 2:UNIT 7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4240
Practice Address - Country:US
Practice Address - Phone:305-342-8692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty