Healthcare Provider Details

I. General information

NPI: 1790616829
Provider Name (Legal Business Name): ADVANCE BALANCE ALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 AVIDA VILLAGE CIR APT 409
ORLANDO FL
32825-6195
US

IV. Provider business mailing address

1051 AVIDA VILLAGE CIR APT 409
ORLANDO FL
32825-6195
US

V. Phone/Fax

Practice location:
  • Phone: 772-607-1008
  • Fax:
Mailing address:
  • Phone: 772-607-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: YILIAN JULIA MONTES DE OCA
Title or Position: OWNER
Credential:
Phone: 772-607-1008