MEDICARE: ADVANCED HEALTHCARE REJUVENATING MEDICINE, 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

General Provider Information

NPI Number	:	1922847615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTHCARE REJUVENATING MEDICINE, LLC

Provider Business Mailing Address
First Line	:	400 EXECUTIVE CENTER DR STE 107
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 EXECUTIVE CENTER DR STE 107
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2919
Country	:	US
Telephone Number	:	561-296-1715
Fax Number	:	561-296-1716

Authorized Official
Title or Position	:	OWNER
Name	:	MIGUEL A MONTERO
Credential	:
Telephone Number	:	954-913-5789

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	05/24/2024

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