Provider Demographics
NPI:1669102877
Name:AVANTI TECHNOLOGIES
Entity type:Organization
Organization Name:AVANTI TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MR
Authorized Official - Phone:703-606-6235
Mailing Address - Street 1:3711 SPICEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2250
Mailing Address - Country:US
Mailing Address - Phone:703-606-6235
Mailing Address - Fax:
Practice Address - Street 1:AIMS AT INTERAMERICAN UNIVERSITY CAMPUS
Practice Address - Street 2:AV. CATALINA SANTIAGO CHICO
Practice Address - City:ARECIBO,
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:703-606-6235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center