Provider Demographics
NPI:1447489935
Name:ADVANTAGE SERVICES GROUP
Entity type:Organization
Organization Name:ADVANTAGE SERVICES GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISSETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-519-4313
Mailing Address - Street 1:8020 CORAL WAY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1225
Mailing Address - Country:US
Mailing Address - Phone:786-206-9085
Mailing Address - Fax:786-347-6367
Practice Address - Street 1:8020 CORAL WAY
Practice Address - Street 2:SUITE 7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1225
Practice Address - Country:US
Practice Address - Phone:786-206-9085
Practice Address - Fax:786-347-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care