| 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 | 07/10/2024 |
| Certification Date | 07/10/2024 |
| 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 | (NU) | Primary |
| Provider Name | Michelle Antoinette Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659336634 PECOS PAC ID: 7416992128 Enrollment ID: I20050623000126 |
| Provider Name | Tamara T Reels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316377203 PECOS PAC ID: 5799911467 Enrollment ID: I20131202001834 |
| 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 | Justin Thomas Chamberland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164019618 PECOS PAC ID: 6901211135 Enrollment ID: I20210219001501 |
| Provider Name | Elizabeth Paige Shinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083203814 PECOS PAC ID: 7214330489 Enrollment ID: I20210726001975 |
| Provider Name | Magdaline J Florvella-pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487314175 PECOS PAC ID: 8820482409 Enrollment ID: I20220224000736 |
| Provider Name | Elaine Rosaci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578206199 PECOS PAC ID: 9739567819 Enrollment ID: I20220601001767 |
| Provider Name | Shannon Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548917537 PECOS PAC ID: 1456727429 Enrollment ID: I20221015000140 |
| Provider Name | Jasmine Montanez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023748803 PECOS PAC ID: 7012388085 Enrollment ID: I20230131000025 |
| Provider Name | Michael Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063929479 PECOS PAC ID: 9234499401 Enrollment ID: I20230217000661 |
| Provider Name | Sheila E Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275232878 PECOS PAC ID: 5890156624 Enrollment ID: I20230726003190 |
| Provider Name | Grant Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619755816 PECOS PAC ID: 3375990914 Enrollment ID: I20231103001614 |
| Provider Name | Nicole Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194588723 PECOS PAC ID: 8628412525 Enrollment ID: I20240220000240 |
| Provider Name | Britney Ebanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427891183 PECOS PAC ID: 8224579966 Enrollment ID: I20240920001665 |
| Provider Name | Carla Denise Meza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437977188 PECOS PAC ID: 1658891783 Enrollment ID: I20250410000152 |
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