1023698503 NPI number — ADVANCED MEDICAL RESEARCH GROUP, INC.

Table of content: (NPI 1023698503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023698503 NPI number — ADVANCED MEDICAL RESEARCH GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED MEDICAL RESEARCH GROUP, INC.
Provider Last Name:
Provider First Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1023698503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3816 HOLLYWOOD BLVD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33021-6750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-993-7638
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3816 HOLLYWOOD BLVD STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-6750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-993-7638
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ORTEGA-MENENDEZ
Authorized Official First Name:
MAITE
Authorized Official Middle Name:
Authorized Official Title or Position:
RESEARCH SITE DIRECTOR
Authorized Official Telephone Number:
954-993-7638

Provider Taxonomy Codes

  • Taxonomy code: 261QR1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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