Healthcare Provider Details
I. General information
NPI: 1043611742
Provider Name (Legal Business Name): AVANTE CARE OF LAUDERHILL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2014
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6700 W COMMERCIAL BLVD
LAUDERHILL FL
33319
US
IV. Provider business mailing address
5900 LAKE ELLENOR DR STE 700
ORLANDO FL
32809-4643
US
V. Phone/Fax
- Phone: 954-741-6700
- Fax: 954-741-6750
- Phone: 407-216-0101
- Fax: 407-318-2477
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | AL11507 |
| License Number State | FL |
VIII. Authorized Official
Name:
KIMBERLY
L.
BIEGASIEWICZ
Title or Position: PRESIDENT
Credential:
Phone: 407-216-0101