| Advanced Healthcare Integration, Llc | |
|
3270 Suntree Blvd Ste 208 Melbourne FL 32940-7505 | |
| (321) 622-4877 | |
| (833) 291-9415 |
| Full Name | Advanced Healthcare Integration, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3270 Suntree Blvd Ste 208, Melbourne, Florida |
| Authorized Official Name and Position | Thomas Lanman (OWNER/OPERATOR) |
| Authorized Official Contact | 3215360587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Healthcare Integration, Llc 3270 Suntree Blvd Ste 208 Melbourne FL 32940-7505 Ph: (321) 536-0587 | Advanced Healthcare Integration, Llc 3270 Suntree Blvd Ste 208 Melbourne FL 32940-7505 Ph: (321) 622-4877 |
| NPI Number | 1821696766 |
|---|---|
| Provider Enumeration Date | 10/13/2020 |
| Last Update Date | 06/19/2023 |
| Medicare PECOS PAC ID | 3476964438 |
|---|---|
| Medicare Enrollment ID | O20201123002014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821696766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Melva J Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750774725 PECOS PAC ID: 1557679768 Enrollment ID: I20151007001501 |
| Provider Name | Laurie A Tacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437767464 PECOS PAC ID: 9830517259 Enrollment ID: I20200917001279 |
| Provider Name | Shana Mccloud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679150338 PECOS PAC ID: 5799188520 Enrollment ID: I20210730000996 |
| Provider Name | Shawndolyn Bruten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629685060 PECOS PAC ID: 6002205812 Enrollment ID: I20211117001660 |
| Provider Name | Luana Pereira Meskauskas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700583465 PECOS PAC ID: 8921473935 Enrollment ID: I20230405000374 |
| Provider Name | Rondanielle Sincerity Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831862945 PECOS PAC ID: 8123423191 Enrollment ID: I20231126000064 |
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