Advantage Medical Group LLC
General Practice in Kissimmee, FL. Organization (NPI-2).
NPI number1932640539
StatusActive
Last updated in NPPESJan 22, 2024
Details
- NPI
- 1932640539
- Entity type
- Organization (NPI-2)
- Legal business name
- Advantage Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Mar 15, 2017
- Certification date
- Jan 22, 2024
- Last updated
- Jan 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 302R00000X | Health Maintenance Organization | – | – |
Practice location
715 E Vine St Ste 1Kissimmee, FL 34744-4232
Phone 407-930-1112 · Fax 407-930-1114
Mailing address
715 E Vine St Ste 1Kissimmee, FL 34744-4232
Phone 407-930-1112 · Fax 407-930-1114
Authorized official
Arcilio Alvarado
Ceo
7873068356
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