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General NPI Number Information
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NPI Number | 1992083240
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH CENTERS INC
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 109 TERRA MANGO LOOP
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City | ORLANDO
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State | FL
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Zip | 32835-8511
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Country | US
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Telephone | 407-522-7540
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Fax | 407-522-7544
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Provider Business Mailing Address
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Address Line | PO BOX 1856
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City | WINDERMERE
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State | FL
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Zip | 34786-1856
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Country | US
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Telephone | 407-522-7540
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Fax | 407-522-7544
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Authorized Official
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Title or Position | OWNER
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Name | DR. IHAN RODRIGUEZ
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Credential | DC
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Telephone | 407-522-7540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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