Provider Demographics
NPI:1952035420
Name:ADVANCED MED HEALTHCARE CENTER LLC
Entity Type:Organization
Organization Name:ADVANCED MED HEALTHCARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:LEYRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-873-1892
Mailing Address - Street 1:9380 SW 72ND ST STE B240
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5483
Mailing Address - Country:US
Mailing Address - Phone:786-747-4734
Mailing Address - Fax:786-747-4809
Practice Address - Street 1:9380 SW 72ND ST STE B240
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5483
Practice Address - Country:US
Practice Address - Phone:786-747-4734
Practice Address - Fax:786-747-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center