=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215941554
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AVANTI HOME HEALTH SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2006
-----------------------------------------------------
Last Update Date | 02/09/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9730 NW 25TH ST 2ND FLOOR
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-805-9370
-----------------------------------------------------
Fax | 305-805-9457
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 227396
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33122-7396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-805-9370
-----------------------------------------------------
Fax | 305-805-9457
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. JULIA C CARDERO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-805-9370
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------