MEDICARE: ADVANCED MOBILE MEDICAL SERVICES

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1912528290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MOBILE MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	5470 E BUSCH BLVD # 461
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-5418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5118 N 56TH ST STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-5440
Country	:	US
Telephone Number	:	813-710-9555
Fax Number	:	813-710-9556

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ERIKA HALL
Credential	:	APRN-C
Telephone Number	:	813-710-9555

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	03/25/2025

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