Provider Demographics
NPI:1972215275
Name:AVANTI FAMILY HEALTH CENTER INC
Entity Type:Organization
Organization Name:AVANTI FAMILY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AGNABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:239-776-8553
Mailing Address - Street 1:1145 IVY WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-5216
Mailing Address - Country:US
Mailing Address - Phone:239-776-8553
Mailing Address - Fax:
Practice Address - Street 1:1145 IVY WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34117-5216
Practice Address - Country:US
Practice Address - Phone:239-776-8553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty