MEDICARE: ADVANCED MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	SA 9179	FL
2	283X00000X	Rehabilitation Hospital	SA 9179	FL

General Provider Information

NPI Number	:	1053506741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL

Provider Business Mailing Address
First Line	:	PO BOX 292
Second Line	:
City	:	LAFAYETTE
State	:	TN
Zip	:	37083-0292
Country	:	US
Telephone Number	:	615-477-2072
Fax Number	:

Provider Business Practice Location Address
First Line	:	681 BEVILLE RD
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-1951
Country	:	US
Telephone Number	:	866-426-2811
Fax Number	:

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST
Name	:	MS. APRIL DAWN STONE
Credential	:	M.S.CCC-SLP
Telephone Number	:	615-477-2072

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	09/06/2007

Similar Medicare Providers

1922178664 — DR. WOLFGANG R MUNSTER D.C.,P.A.
Practice Location Address:

687 BEVILLE RD , SUITE B
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 386-322-9800
Practice Fax: 386-322-9808

1598838419 — W R MUNSTER DC PA
Practice Location Address:

687 BEVILLE RD , SUITE B
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 386-322-9800
Practice Fax: 386-322-9808

1962621086 — KATHLEEN ANN MANNING PTA
Practice Location Address:

681 BEVILLE RD
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 386-756-4395
Practice Fax:

1831399005 — MRS. MARSHA LYN KLOPFENSTEIN
Practice Location Address:

681 BEVILLE RD
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 800-330-7711
Practice Fax: 866-426-2811

1881888709 — MS. DEBORAH ASHLEY MULLIN CCC-SLP
Practice Location Address:

681 BEVILLE RD
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 866-426-2811
Practice Fax:

1467640474 — WANDA GAYLE ELLISON LPTA
Practice Location Address:

681 BEVILLE RD
SOUTH DAYTONA, FL
32119-1951

Practice Phone: 800-330-7711
Practice Fax:

Directions to “ADVANCED MEDICAL ” Practice Location

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