Healthcare Provider Details

I. General information

NPI: 1992734982
Provider Name (Legal Business Name): ADVANCED MEDICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 SCENIC ST
LEESBURG FL
34748-6226
US

IV. Provider business mailing address

618 SCENIC ST
LEESBURG FL
34748-6226
US

V. Phone/Fax

Practice location:
  • Phone: 352-303-6143
  • Fax: 352-728-3719
Mailing address:
  • Phone: 352-303-6143
  • Fax: 352-728-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME31278
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberPMD510306
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberME31278
License Number StateFL

VIII. Authorized Official

Name: MICHAEL ANGELO ANDERSON
Title or Position: PARTNER
Credential: EMT-P
Phone: 352-303-6143