MEDICARE: AMERICAN MEDICAL MOBILITY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1717	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R9320	OTHER	FL	BLUECROSSBLUESHIELD NUMBE

General Provider Information

NPI Number	:	1336145119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL MOBILITY LLC

Provider Business Mailing Address
First Line	:	3716 NW 97TH BLVD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-5065
Country	:	US
Telephone Number	:	352-331-6565
Fax Number	:	352-331-6595

Provider Business Practice Location Address
First Line	:	3716 NW 97TH BLVD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-5065
Country	:	US
Telephone Number	:	352-331-6565
Fax Number	:	352-331-6595

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VALERIE GANN COX
Credential	:
Telephone Number	:	352-331-6565

Provider Enumeration Date	:	06/25/2005
Last Update Date	:	08/22/2020

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