Provider Demographics
NPI:1962987610
Name:ADVANCED NEUROTHERAPEUTICS LLC
Entity type:Organization
Organization Name:ADVANCED NEUROTHERAPEUTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RODRIGUEZ-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-916-0304
Mailing Address - Street 1:11954 NARCOOSSEE RD #2
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832
Mailing Address - Country:US
Mailing Address - Phone:407-916-0304
Mailing Address - Fax:
Practice Address - Street 1:92 N DEAN RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3769
Practice Address - Country:US
Practice Address - Phone:407-916-0304
Practice Address - Fax:888-960-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty