| Avanti Wellness Center Inc | |
|
165 Southpark Blvd Suite D St Augustine FL 32086-4101 | |
| (904) 824-7597 | |
| (904) 824-7598 |
| Full Name | Avanti Wellness Center Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 165 Southpark Blvd, St Augustine, Florida |
| Authorized Official Name and Position | Denise R Odom (OFFICE MANAGER) |
| Authorized Official Contact | 9048247597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avanti Wellness Center Inc 165 Southpark Blvd Suite D St Augustine FL 32086-4101 Ph: (904) 824-7597 | Avanti Wellness Center Inc 165 Southpark Blvd Suite D St Augustine FL 32086-4101 Ph: (904) 824-7597 |
| NPI Number | 1861403974 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861403974 | NPI | - | NPPES |
| HCC7024 | Other | FL | MEDICAL LICENSE NUMBER |
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