Provider Demographics
NPI:1023435740
Name:ADVANCE PROFESSIONAL CENTER INC
Entity type:Organization
Organization Name:ADVANCE PROFESSIONAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-458-3057
Mailing Address - Street 1:11890 SW 8TH ST
Mailing Address - Street 2:406
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1743
Mailing Address - Country:US
Mailing Address - Phone:786-458-3057
Mailing Address - Fax:786-703-5085
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:406
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1743
Practice Address - Country:US
Practice Address - Phone:786-458-3057
Practice Address - Fax:786-703-5085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy