Healthcare Provider Details

I. General information

NPI: 1871670067
Provider Name (Legal Business Name): AVANTE AT LAKE WORTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N A ST
LAKE WORTH FL
33460-6013
US

IV. Provider business mailing address

5900 LAKE ELLENOR DR STE 700
ORLANDO FL
32809-4643
US

V. Phone/Fax

Practice location:
  • Phone: 561-585-9301
  • Fax: 561-533-5857
Mailing address:
  • Phone: 407-216-0101
  • Fax: 407-318-2477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF10250961
License Number StateFL

VIII. Authorized Official

Name: KIMBERLY L. BIEGASIWICZ
Title or Position: PRESIDENT
Credential:
Phone: 407-216-0101