Healthcare Provider Details

I. General information

NPI: 1184894370
Provider Name (Legal Business Name): ADVANCE HEALTH SERVICES III INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 SUNSET DR STE 130
MIAMI FL
33173-3295
US

IV. Provider business mailing address

9425 SUNSET DR STE 130
MIAMI FL
33173-3295
US

V. Phone/Fax

Practice location:
  • Phone: 305-216-1964
  • Fax: 305-670-0054
Mailing address:
  • Phone: 305-216-1964
  • Fax: 305-670-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS GOETZ
Title or Position: DIRECTOR
Credential: D.C.
Phone: 305-670-0055