Healthcare Provider Details

I. General information

NPI: 1427896059
Provider Name (Legal Business Name): AMS NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 N PALAFOX ST
PENSACOLA FL
32502-5626
US

IV. Provider business mailing address

28 N PALAFOX ST
PENSACOLA FL
32502-5626
US

V. Phone/Fax

Practice location:
  • Phone: 941-961-8697
  • Fax:
Mailing address:
  • Phone: 941-961-8697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DAVID SIMPSON
Title or Position: OWNER
Credential: MD
Phone: 941-961-8697