Provider Demographics
NPI:1215941554
Name:AVANTI HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:AVANTI HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-9370
Mailing Address - Street 1:PO BOX 227396
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-7396
Mailing Address - Country:US
Mailing Address - Phone:305-805-9370
Mailing Address - Fax:305-805-9457
Practice Address - Street 1:9730 NW 25TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2201
Practice Address - Country:US
Practice Address - Phone:305-805-9370
Practice Address - Fax:305-805-9457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651172400Medicaid
FL108255Medicare Oscar/Certification