Active NPI
Advance Therapy Works Inc
- Rehabilitation Clinic/Center
- Miami, FL
National Provider Identifier
1104919653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Clinic/Center
- License
- HCC8245
- Legal business name
- ADVANCE THERAPY WORKS INC
- Practice address
- 12060 SW 129TH CT
Suite 107
Miami, FL 33186-4581 - Phone
- (305) 378-5247
- Fax
- (305) 378-6760
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Luz Stella Fuentes, O.T
- Title
- President
- Phone
- (305) 378-5247
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | HCC8245 | FL | Primary |
Addresses
Primary practice location
12060 SW 129TH CT
Suite 107
Miami, FL 33186-4581
Mailing address
12060 SW 129TH CT
Suite 107
Miami, FL 33186-4581
Phone (305) 378-5247
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686115696 | Medicaid | FL | |
| 887899400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080507000312 | FL | Part B Supplier - Clinic/Group Practice | 2365521911 |
Receives reassigned benefits from 8 practitioners Practice locations: Miami, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Advance Therapy Works
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Speech-Language Pathologist
- Miami, FL
- NPI 1871998039
-
- Occupational Therapy Assistant
- Miami, FL
- NPI 1023438348
Locations
12060 SW 129th Ct
Ste 107
Miami, FL 33186
Phone (305) 378-5247
14540 SW 136th St
Ste 210
Miami, FL 33186
Phone (305) 378-5247
Practitioners & affiliated clinicians
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Hialeah, FL
- NPI 1598109316
-
- Physical Therapist
- Miami, FL
- NPI 1558450213
-
- Developmental Therapist
- Miami, FL
- NPI 1740460104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1414108800000",
"number": "1104919653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12060 SW 129TH CT",
"address_2": "SUITE 107",
"city": "MIAMI",
"state": "FL",
"postal_code": "331864581",
"telephone_number": "305-378-5247",
"fax_number": "305-378-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12060 SW 129TH CT",
"address_2": "SUITE 107",
"city": "MIAMI",
"state": "FL",
"postal_code": "331864581",
"telephone_number": "305-378-5247",
"fax_number": "305-378-6760"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCE THERAPY WORKS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2014-10-24",
"status": "A",
"authorized_official_last_name": "FUENTES",
"authorized_official_first_name": "LUZ",
"authorized_official_middle_name": "STELLA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "305-378-5247",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "O.T"
},
"taxonomies": [
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": "FL",
"license": "HCC8245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "686115696",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "887899400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.