Healthcare Provider Details

I. General information

NPI: 1336687953
Provider Name (Legal Business Name): ADVANCED MULTISPECIALTY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 SW 62ND AVE
SOUTH MIAMI FL
33143-4701
US

IV. Provider business mailing address

1475 W 49TH ST
HIALEAH FL
33012-3222
US

V. Phone/Fax

Practice location:
  • Phone: 305-824-4795
  • Fax:
Mailing address:
  • Phone: 305-824-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: SANDY SOSA-GUERRERO
Title or Position: CEO
Credential:
Phone: 305-284-7700