Provider Demographics
NPI:1942873476
Name:ADVENT HEALTH
Entity Type:Organization
Organization Name:ADVENT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SHAYE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-288-9513
Mailing Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7665
Mailing Address - Country:US
Mailing Address - Phone:407-930-7803
Mailing Address - Fax:
Practice Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7665
Practice Address - Country:US
Practice Address - Phone:407-930-7803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy