Provider Demographics
NPI:1902298128
Name:ADVANCED CARE SERVICES, INC
Entity Type:Organization
Organization Name:ADVANCED CARE SERVICES, INC
Other - Org Name:J&C HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CORADIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:954-501-5274
Mailing Address - Street 1:1620 NE 148TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1021
Mailing Address - Country:US
Mailing Address - Phone:786-298-7379
Mailing Address - Fax:
Practice Address - Street 1:1620 NE 148TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1021
Practice Address - Country:US
Practice Address - Phone:305-705-6445
Practice Address - Fax:888-890-6583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000441500Medicaid
FL006246600Medicaid