Healthcare Provider Details

I. General information

NPI: 1295449544
Provider Name (Legal Business Name): ADVANCED CARE SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13195 SW 134TH ST STE 102
MIAMI FL
33186-4585
US

IV. Provider business mailing address

13195 SW 134TH ST STE 102
MIAMI FL
33186-4585
US

V. Phone/Fax

Practice location:
  • Phone: 305-934-0445
  • Fax:
Mailing address:
  • Phone: 305-964-5236
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YANELIS GIL
Title or Position: OWNER
Credential: APRN
Phone: 305-934-0445