Advance Medical Group LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ADVANCE MEDICAL GROUP LLC

Practice address

3400 Coral Way Ste 603
Miami, FL 33145-3070

Phone

(305) 772-8107

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Lexander Gonzalez

Title

Owner

Phone

(305) 772-8107

Specialties & licenses 1

Addresses

Other names 1

• ADVANCE BEHAVIORAL THERAPIST LLC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1144938549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 603",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453070",
            "telephone_number": "305-772-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 603",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453070",
            "telephone_number": "305-772-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-772-8107"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCE BEHAVIORAL THERAPIST LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVANCE BEHAVIORAL THERAPIST LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Miami, FL
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.