Healthcare Provider Details

I. General information

NPI: 1306294350
Provider Name (Legal Business Name): AMOROS MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 TAMIAMI TRL UNIT E
PORT CHARLOTTE FL
33952-8128
US

IV. Provider business mailing address

PO BOX 495009
PORT CHARLOTTE FL
33949-5009
US

V. Phone/Fax

Practice location:
  • Phone: 941-206-5200
  • Fax: 941-206-3322
Mailing address:
  • Phone: 941-206-5200
  • Fax: 941-206-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA AMOROS-MUJICA
Title or Position: OWNER
Credential: MD
Phone: 305-542-3114