Healthcare Provider Details

I. General information

NPI: 1497392187
Provider Name (Legal Business Name): AMS AA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 N PALAFOX ST
PENSACOLA FL
32502-5626
US

IV. Provider business mailing address

PO BOX 919747
ORLANDO FL
32891-9747
US

V. Phone/Fax

Practice location:
  • Phone: 866-653-2540
  • Fax:
Mailing address:
  • Phone: 866-653-2540
  • Fax: 941-269-4451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID SIMPSON
Title or Position: MEMBER/OWNER
Credential: MD
Phone: 866-653-2450