Healthcare Provider Details
I. General information
NPI: 1386092427
Provider Name (Legal Business Name): AMP GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/31/2016
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2464 SW 22ND ST
MIAMI FL
33145-3419
US
IV. Provider business mailing address
2464 SW 22ND ST
MIAMI FL
33145-3419
US
V. Phone/Fax
- Phone: 305-204-9355
- Fax: 305-640-8034
- Phone: 305-204-9355
- Fax: 305-640-8034
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SA2100X |
| Taxonomy | Acute Care Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LILY
OQUENDO
Title or Position: PRACTICE MANAGER
Credential:
Phone: 305-204-9355