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General NPI Number Information
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NPI Number | 1922954015
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Entity Type | Organization
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Legal Business Name | AVANTI CLINICAL RESEARCH CORP
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 214
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City | HIALEAH
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State | FL
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Zip | 33013-3850
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Country | US
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Telephone | 786-755-4815
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Fax | 786-755-4821
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Provider Business Mailing Address
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Address Line | 777 E 25TH ST STE 214
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City | HIALEAH
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State | FL
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Zip | 33013-3850
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Country | US
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Telephone | 786-755-4815
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Fax | 786-755-4821
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Authorized Official
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Title or Position | OWNER
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Name | JOSE E VILLASUSO MORALES
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Credential | DNP, APRN- FNP
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Telephone | 786-755-4815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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