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Organization
ADVANCED REGENERATIVE HEALTH LLC
Active
Organization
ADVANCED REGENERATIVE HEALTH LLC
Active
Parent organization
ADVANCED REGENERATIVE HEALTH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED REGENERATIVE HEALTH LLC
Authorized official
MR. JORDAN AUGUSTIN APRN, PMHNP-BC (OWNER, CEO)
(954) 461-3172
Entity
Organization
Contact information
Practice address
5100 N FEDERAL HWY STE 100, FORT LAUDERDALE, FL 33308-3842
(754) 268-3108
Mailing address
1870 N CORPORATE LAKES BLVD UNIT 267021, WESTON, FL 33326-8837
(754) 268-3108
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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