MEDICARE: ADVANTIS HOME CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HHA299992041	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10-8275	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235216839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTIS HOME CARE, INC.

Provider Business Mailing Address
First Line	:	8801 SW 132ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-5926
Country	:	US
Telephone Number	:	305-631-1075
Fax Number	:	305-631-1590

Provider Business Practice Location Address
First Line	:	8801 SW 132ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-5926
Country	:	US
Telephone Number	:	305-631-1075
Fax Number	:	305-631-1590

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JESSICA M TAGLE
Credential	:
Telephone Number	:	305-631-1075

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/26/2023

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Directions to “ADVANTIS HOME CARE, INC. ” Practice Location

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