Provider Demographics
NPI:1366112062
Name:ADVANCED HEALTHCARE CENTERS, LLC
Entity type:Organization
Organization Name:ADVANCED HEALTHCARE CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-930-2546
Mailing Address - Street 1:7008 N HIMES AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4005
Mailing Address - Country:US
Mailing Address - Phone:813-930-2546
Mailing Address - Fax:813-461-6899
Practice Address - Street 1:7008 N HIMES AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4005
Practice Address - Country:US
Practice Address - Phone:813-930-2546
Practice Address - Fax:813-461-6899
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED HEALTHCARE CENTERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care