Provider Demographics
NPI:1922847615
Name:ADVANCED HEALTHCARE REJUVENATING MEDICINE, LLC
Entity type:Organization
Organization Name:ADVANCED HEALTHCARE REJUVENATING MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-913-5789
Mailing Address - Street 1:400 EXECUTIVE CENTER DR STE 107
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 EXECUTIVE CENTER DR STE 107
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2919
Practice Address - Country:US
Practice Address - Phone:561-296-1715
Practice Address - Fax:561-296-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty