Healthcare Provider Details

I. General information

NPI: 1215868393
Provider Name (Legal Business Name): ADVANCED PRACTITIONER SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 BOWMAN ST
CLERMONT FL
34711-3144
US

IV. Provider business mailing address

109 AMBERSWEET WAY STE 642
DAVENPORT FL
33897-8418
US

V. Phone/Fax

Practice location:
  • Phone: 732-599-0690
  • Fax: 845-327-1074
Mailing address:
  • Phone: 732-599-0690
  • Fax: 845-327-1074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR KHARONOV
Title or Position: OWNER
Credential: FNP
Phone: 732-599-0690