Provider Demographics
NPI:1306116009
Name:ADVANTACARE OF FLORIDA, LLC
Entity type:Organization
Organization Name:ADVANTACARE OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:386-248-0107
Mailing Address - Street 1:697 MAITLAND AVE
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6821
Mailing Address - Country:US
Mailing Address - Phone:407-539-2111
Mailing Address - Fax:407-539-1211
Practice Address - Street 1:697 MAITLAND AVE
Practice Address - Street 2:SUITE1001
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6821
Practice Address - Country:US
Practice Address - Phone:407-539-2111
Practice Address - Fax:407-539-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42566207QA0505X
FLME98460208VP0014X
FLME86688208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty