Provider Demographics
NPI:1992870554
Name:ADVANCED HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:ADVANCED HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-924-3022
Mailing Address - Street 1:4141 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 18
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3600
Mailing Address - Country:US
Mailing Address - Phone:941-924-3022
Mailing Address - Fax:941-925-4943
Practice Address - Street 1:4141 S TAMIAMI TRL
Practice Address - Street 2:SUITE 18
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3600
Practice Address - Country:US
Practice Address - Phone:941-924-3022
Practice Address - Fax:941-925-4943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDEPT. OF LABOROtherWORKER'S COMPENSATION
FL00202OtherUNIVERSAL HEALTHCARE
FL227407OtherAMERIGROUP
FLY907NOtherBCBS FACILITY GROUP
FL0812318OtherAETNA HMO ONLY
FL247344OtherAVMED
FLK0852Medicare ID - Type UnspecifiedGROUP NUMBER