MEDICARE: ADVANCED HEALTH CARE LLC

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	111N00000X	Chiropractor	CH7201	FL

General Provider Information

NPI Number	:	1083151633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	4101 W CYPRESS ST STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2302
Country	:	US
Telephone Number	:	813-513-4461
Fax Number	:	813-513-4836

Provider Business Practice Location Address
First Line	:	4101 W CYPRESS ST STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2302
Country	:	US
Telephone Number	:	813-513-4461
Fax Number	:	813-513-4836

Authorized Official
Title or Position	:	PRESIDENT / DIRECTOR
Name	:	DR. RAMONA VALENTINE
Credential	:	DC
Telephone Number	:	813-613-4461

Provider Enumeration Date	:	01/20/2017
Last Update Date	:	01/20/2017

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