Healthcare Provider Details

I. General information

NPI: 1114965886
Provider Name (Legal Business Name): ADVANCE HEALTH AND WELLNESS SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2724 PONCE DE LEON BLVD
CORAL GABLES FL
33134-6005
US

IV. Provider business mailing address

2724 PONCE DE LEON BLVD
CORAL GABLES FL
33134-6005
US

V. Phone/Fax

Practice location:
  • Phone: 786-360-6355
  • Fax: 786-536-4319
Mailing address:
  • Phone: 786-360-6355
  • Fax: 786-536-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: HUMBERTO RODRIGUEZ
Title or Position: PRESIDENT CEO
Credential: DC
Phone: 786-360-6355