Healthcare Provider Details

I. General information

NPI: 1013204577
Provider Name (Legal Business Name): ADVANCED DIAGNOSTIC SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19902 GUNN HWY
ODESSA FL
33556-4506
US

IV. Provider business mailing address

19902 GUNN HWY
ODESSA FL
33556-4506
US

V. Phone/Fax

Practice location:
  • Phone: 727-707-3631
  • Fax:
Mailing address:
  • Phone: 727-707-3631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. BRANDON M WOMACK
Title or Position: CEO
Credential:
Phone: 727-707-3631