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NPI Code Detail

MEDICARE: ADVANCED HEALTH CARE GROUP, INC

MEDICARE: ADVANCED HEALTH CARE GROUP, 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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician
2111NR0400XRehabilitation Chiropractor

General Provider Information

NPI Number : 1407134075
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED HEALTH CARE GROUP, INC
Provider Business Mailing Address
First Line : PO BOX 2820
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-2820
Country : US
Telephone Number : 407-933-1500
Fax Number : 407-933-1504
Provider Business Practice Location Address
First Line : 711 E OAK ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-4573
Country : US
Telephone Number : 407-933-1500
Fax Number : 407-933-1504
Authorized Official
Title or Position : OWNER
Name : DR. IHAN RODRGUEZ
Credential : DC
Telephone Number : 407-933-1500
Provider Enumeration Date : 07/29/2011
Last Update Date : 08/03/2011

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Directions to “ADVANCED HEALTH CARE GROUP, INC ” Practice Location

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