Organization Active NPI

Advantacare Multi-Specialty Group, LLC

  • Physical Medicine & Rehabilitation Physician
  • Orlando, FL
National Provider Identifier
1174982169
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ADVANTACARE MULTI-SPECIALTY GROUP, LLC
Practice address
815 Good Homes Rd
Orlando, FL 32818-6628
Phone
(407) 601-7940
Fax
(407) 704-6943
NPI assigned
Feb 18, 2016
Last updated
Feb 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Kerri Herzog
Title
Member
Phone
(407) 539-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

815 Good Homes Rd
Orlando, FL 32818-6628

Mailing address

697 Maitland Ave
Suite 1001
Altamonte Springs, FL 32701-6821
Phone (407) 539-2111

National Provider Directory

National Provider Directory

Locations

815 Good Homes Rd
Orlando, FL 32818
Phone (407) 601-7940

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1174982169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 MAITLAND AVE",
            "address_2": "SUITE 1001",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016821",
            "telephone_number": "407-539-2111",
            "fax_number": "407-539-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 GOOD HOMES RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186628",
            "telephone_number": "407-601-7940",
            "fax_number": "407-704-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTACARE MULTI-SPECIALTY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "407-539-2111"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.