Provider Demographics
NPI:1700607934
Name:ADVENTURE MEDICAL CENTER INC
Entity type:Organization
Organization Name:ADVENTURE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-456-5693
Mailing Address - Street 1:85 GRAND CANAL DR STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2564
Mailing Address - Country:US
Mailing Address - Phone:305-456-5693
Mailing Address - Fax:786-464-0342
Practice Address - Street 1:85 GRAND CANAL DR STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2564
Practice Address - Country:US
Practice Address - Phone:305-456-5693
Practice Address - Fax:786-464-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty