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General NPI Number Information
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NPI Number | 1689931834
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Entity Type | Organization
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Legal Business Name | ADVANCE HEALTH SOLUTIONS, INC.
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 2336 CLEVELAND AVE STE B
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City | FORT MYERS
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State | FL
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Zip | 33901-3540
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Country | US
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Telephone | 305-978-5436
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Fax | 239-288-7458
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Provider Business Mailing Address
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Address Line | 2336 CLEVELAND AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-3540
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Country | US
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Telephone | 305-978-5436
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Fax | 239-288-7458
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | LIVAN RODRIGUEZ
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Credential | MASSAGE THERAPIST
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Telephone | 239-288-7457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MM28888
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License Number State | FL
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