Provider Demographics
NPI:1902297310
Name:CARE ADVANTAGE LLC
Entity Type:Organization
Organization Name:CARE ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:321-221-7447
Mailing Address - Street 1:PO BOX 540547
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32954-0547
Mailing Address - Country:US
Mailing Address - Phone:321-221-7447
Mailing Address - Fax:
Practice Address - Street 1:284 S BREVARD AVE
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-2797
Practice Address - Country:US
Practice Address - Phone:321-221-7447
Practice Address - Fax:321-221-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty