MEDICARE: ADVANTA WELLNESS

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	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1235094426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTA WELLNESS

Provider Business Mailing Address
First Line	:	521 N ADAMS ST STE G
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-3903
Country	:	US
Telephone Number	:	804-873-0147
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 N ADAMS ST STE G
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-3903
Country	:	US
Telephone Number	:	804-873-0147
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AMIRA ABDELAGID
Credential	:
Telephone Number	:	804-873-0147

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	01/03/2026

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Directions to “ADVANTA WELLNESS ” Practice Location

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