Healthcare Provider Details

I. General information

NPI: 1598794158
Provider Name (Legal Business Name): MICHAEL LOUIS AMOROSO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 UNIVERSITY PKWY SUITE 104
SARASOTA FL
34243-2893
US

IV. Provider business mailing address

2401 UNIVERSITY PKWY SUITE 104
SARASOTA FL
34243-2893
US

V. Phone/Fax

Practice location:
  • Phone: 941-357-1773
  • Fax: 941-256-7452
Mailing address:
  • Phone: 941-357-1773
  • Fax: 941-256-7452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA04142300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: