NPIMap

Organization Active NPI

Advance Therapy Works Inc

  • Rehabilitation Clinic/Center
  • Miami, FL
National Provider Identifier
1104919653
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
HCC8245 Issued in FL
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
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Luz Stella Fuentes, O.TNPI 1083716807
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)CodeLicenseStatePrimary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Works3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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, and the practitioner matching its NPPES authorized official.

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": [],
    "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.

Verify at the official NPI Registry.