MEDICARE: AVANTE CARE ANCILLARY SERVICES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251G0304X	Geriatric Physical Therapist
2	251J00000X	Nursing Care Agency
3	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1851455901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVANTE CARE ANCILLARY SERVICES, INC.

Provider Business Mailing Address
First Line	:	4000 HOLLYWOOD BLVD
Second Line	:	SUITE 540 NORTH
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6751
Country	:	US
Telephone Number	:	954-987-7180
Fax Number	:	954-989-5287

Provider Business Practice Location Address
First Line	:	4000 HOLLYWOOD BLVD
Second Line	:	SUITE 540 NORTH
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6751
Country	:	US
Telephone Number	:	954-987-7180
Fax Number	:	954-989-5287

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DEAN J DICKMANN
Credential	:
Telephone Number	:	954-987-7180

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	06/04/2008

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