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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
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
10/09/2023
Last updated
10/09/2023
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