Avanti Rehab Group

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Legal business name

AVANTI REHAB GROUP

Practice address

6079 W Maple Rd
Suite 110-B
West Bloomfield, MI 48322-2283

Phone

(248) 626-2416

Fax

(248) 626-3918

NPI assigned

Sep 29, 2010

Organization subpart

No

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

Authorized official

Name

Jose Evangelista, M.D.

Title

Owner

Phone

(248) 626-2416

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1508175233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6079 W MAPLE RD",
            "address_2": "SUITE 110-B",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222283",
            "telephone_number": "248-626-2416",
            "fax_number": "248-626-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6079 W MAPLE RD",
            "address_2": "SUITE 110-B",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222283",
            "telephone_number": "248-626-2416",
            "fax_number": "248-626-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTI REHAB GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-626-2416",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Practitioner in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Rehabilitation Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.