MEDICARE: ADVANCE BALANCE ALLIANCE 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790616829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE BALANCE ALLIANCE LLC

Provider Business Mailing Address
First Line	:	1051 AVIDA VILLAGE CIR APT 409
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-6195
Country	:	US
Telephone Number	:	772-607-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 AVIDA VILLAGE CIR APT 409
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-6195
Country	:	US
Telephone Number	:	772-607-1008
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YILIAN JULIA MONTES DE OCA
Credential	:
Telephone Number	:	772-607-1008

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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