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General NPI Number Information
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NPI Number | 1881939809
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Entity Type | Organization
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Legal Business Name | ADVANCE RHEUMATOLOGY SERVICES INC
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 206 FOXTAIL DR APT G2
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City | GREENACRES
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State | FL
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Zip | 33415-6014
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Country | US
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Telephone | 772-224-4702
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Fax |
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Provider Business Mailing Address
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Address Line | 206 FOXTAIL DR APT G2
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City | GREEN ACRES
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State | FL
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Zip | 33415
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDUARDO BALBUENA ORDONEZ
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Credential |
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Telephone | 772-224-4702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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