Provider Demographics
NPI:1205680147
Name:ADVANCE ACHIEVER ACADEMY FL, LLC
Entity type:Organization
Organization Name:ADVANCE ACHIEVER ACADEMY FL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-444-6003
Mailing Address - Street 1:713 W PALM DR
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-3223
Mailing Address - Country:US
Mailing Address - Phone:786-444-6003
Mailing Address - Fax:
Practice Address - Street 1:713 W PALM DR
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3223
Practice Address - Country:US
Practice Address - Phone:786-444-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty