Provider Demographics
NPI:1396628004
Name:ADVANCE COMMUNITY SERVICES CORP
Entity type:Organization
Organization Name:ADVANCE COMMUNITY SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAMILET
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-808-6575
Mailing Address - Street 1:1010 10TH AVE N STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2167
Mailing Address - Country:US
Mailing Address - Phone:561-249-7738
Mailing Address - Fax:561-360-3670
Practice Address - Street 1:1010 10TH AVE N STE 2
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2167
Practice Address - Country:US
Practice Address - Phone:561-249-7738
Practice Address - Fax:561-360-3670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center