Avanti Wellness Center
LBN: Avanti Wellness Center Flllp
Avanti Wellness Center is an health care organization with primary practice located at 3574 Us 1 S Suite 113, St Augustine FL 32086-6466. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Avanti Wellness Center Flllp can be contacted via phone (904) 797-3115, or through Brazer, Randi B via phone (904) 797-3115.
Contact Information
Primary practice address
3574 Us 1 S Suite 113
St Augustine FL 32086-6466
Phone: (904) 797-3115
Fax: (904) 797-2915
Website:
Authorized official contact:
Name: Brazer, Randi B Licensed Clinical Social Worker (LCSW)
Phone: (904) 797-3115
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ||
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | HCC7499 | Florida |
Profile Details
| NPI number | 1528200029 |
|---|---|
| LBN Legal business name | Avanti Wellness Center Flllp |
| DBA Doing business as | Avanti Wellness Center |
| Authorized official | Brazer, Randi B Licensed Clinical Social Worker (LCSW) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 30th, 2009 |
| Last updated | Aug 18th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528200029 | NPPES |
| Florida | MEDICAID | 001136302 |
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