Organization
AVANTI WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINA HERNANDEZ (ADMINISTRATOR)
(904) 824-7597
Entity
Organization
Contact information
Practice address
165 SOUTHPARK BLVD, SUITE D, ST AUGUSTINE, FL 32086-4101
(904) 824-7597
(904) 824-7598
Mailing address
165 SOUTHPARK BLVD, SUITE D, ST AUGUSTINE, FL 32086-4101
(904) 824-7597
(904) 824-7598
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
HCC7024
FL
Other
Enumeration date
05/12/2006
Last updated
01/30/2008
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