Advanced Wellness Services Corp
Organization Active NPI Community/Behavioral Health Agency · Miami Lakes, FL
NPI 1942937255 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1942937255
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- ADVANCED WELLNESS SERVICES CORP
- Practice address
- 14100 Palmetto Frntg Rd Ste 107
Miami Lakes, FL 33016-1568 - Phone
- (786) 536-2945
- Fax
- (786) 565-3955
- NPI assigned
- Aug 5, 2022
- Organization subpart
- No
Authorized official
- Name
- Anabel Fernandez
- Title
- Manager
- Phone
- (786) 536-2945
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Advanced Wellness Services Corp
Locations
14100 Palmetto Frntg Rd
Ste 112
Miami Lakes, FL 33016
Phone (786) 296-2773
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
14100 Palmetto Frntg Rd Ste 107
Miami Lakes, FL 33016-1568
Mailing address
14100 Palmetto Frntg Rd Ste 112
Miami Lakes, FL 33016-1568
Phone (786) 536-2945
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113667200 | Medicaid | FL |
Other names
- Advanced Wellness Services Corp
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.