1699294876 NPI number — ADVANCED MEDICAL AND CONSULTING SERVICES

Table of content: (NPI 1699294876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699294876 NPI number — ADVANCED MEDICAL AND CONSULTING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED MEDICAL AND CONSULTING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699294876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 SW 60TH STREET RD
Provider Second Line Business Mailing Address:
# 1608
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34474-4706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-415-6122
Provider Business Mailing Address Fax Number:
352-304-6351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2613 SW 176TH LOOP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34473-6603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-415-6122
Provider Business Practice Location Address Fax Number:
352-358-0515
Provider Enumeration Date:
09/19/2017

Additional Information

Authorized Official

Authorized Official Last Name:
RAMIREZ
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-415-6122

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 022310200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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