Organization
ADVANCE THERAPY WORKS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUZ STELLA FUENTES O.T (PRESIDENT)
(305) 378-5247
Entity
Organization
Contact information
Practice address
12060 SW 129TH CT, SUITE 107, MIAMI, FL 33186-4581
(305) 378-5247
(305) 378-6760
Mailing address
12060 SW 129TH CT, SUITE 107, MIAMI, FL 33186-4581
(305) 378-5247
(305) 378-6760
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC8245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686115696
—
FL
05
—
887899400
—
FL
Enumeration date
10/02/2006
Last updated
10/24/2014
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