Healthcare Provider Details

I. General information

NPI: 1861345290
Provider Name (Legal Business Name): ADVANCED HEALTH ENTERPRISE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 HEALTH BLVD STE A
DAYTONA BEACH FL
32114-1499
US

IV. Provider business mailing address

569 HEALTH BLVD STE A
DAYTONA BEACH FL
32114-1499
US

V. Phone/Fax

Practice location:
  • Phone: 386-846-6568
  • Fax: 386-515-8235
Mailing address:
  • Phone: 386-846-6568
  • Fax: 386-515-8235

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: MRS. SAMANTHA SNOWDEN
Title or Position: APRN
Credential:
Phone: 386-846-6568