# ADVANCED REGENERATIVE HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADVANCED REGENERATIVE HEALTH LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780465559
- **Legal business name:** ADVANCED REGENERATIVE HEALTH LLC
- **Authorized official:** MR. JORDAN AUGUSTIN APRN, PMHNP-BC (OWNER, CEO)
- **Authorized official phone:** (954) 461-3172

## Contact information

- **Practice address:** 5100 N FEDERAL HWY STE 100, FORT LAUDERDALE, FL 33308-3842
- **Practice address phone:** (754) 268-3108
- **Mailing address:** 1870 N CORPORATE LAKES BLVD UNIT 267021, WESTON, FL 33326-8837
- **Mailing address phone:** (754) 268-3108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/09/2023
- **Last updated:** 10/09/2023