MEDICARE: ADVANCED SUPPORT COORDINATION SERVICES, INC.

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1407226830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SUPPORT COORDINATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	11117 W OKEECHOBEE RD STE 115
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4200
Country	:	US
Telephone Number	:	305-351-6133
Fax Number	:	786-703-1299

Provider Business Practice Location Address
First Line	:	11117 W OKEECHOBEE RD STE 115
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4200
Country	:	US
Telephone Number	:	305-351-6133
Fax Number	:	786-703-1299

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROBERTO A. PIRE
Credential	:
Telephone Number	:	305-351-6133

Provider Enumeration Date	:	09/28/2015
Last Update Date	:	09/28/2015

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