Healthcare Provider Details

I. General information

NPI: 1598762809
Provider Name (Legal Business Name): AMERICAN MEDICAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 WESTERHAM LOOP
TRINITY FL
34655-7155
US

IV. Provider business mailing address

1529 WESTERHAM LOOP
TRINITY FL
34655-7155
US

V. Phone/Fax

Practice location:
  • Phone: 727-375-0134
  • Fax: 727-375-0134
Mailing address:
  • Phone: 727-375-0134
  • Fax: 727-375-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANIELLE - PAVLOSKI
Title or Position: DIRECTOR CPT INFORMATION SERVICES
Credential: RHT
Phone: 312-464-4723