Healthcare Provider Details

I. General information

NPI: 1003583865
Provider Name (Legal Business Name): ADVANCED HEALTH MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8650 CORAL WAY
MIAMI FL
33155-2338
US

IV. Provider business mailing address

8650 CORAL WAY
MIAMI FL
33155-2338
US

V. Phone/Fax

Practice location:
  • Phone: 305-539-0599
  • Fax:
Mailing address:
  • Phone: 305-539-0599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AYMEE HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-444-6003