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General NPI Number Information
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NPI Number | 1023698503
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL RESEARCH GROUP, INC.
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 3816 HOLLYWOOD BLVD STE 205
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6750
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Country | US
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Telephone | 954-993-7638
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Fax |
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Provider Business Mailing Address
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Address Line | 3816 HOLLYWOOD BLVD STE 205
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6750
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Country | US
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Telephone | 954-993-7638
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Fax |
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Authorized Official
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Title or Position | RESEARCH SITE DIRECTOR
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Name | DR. MAITE ORTEGA-MENENDEZ
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Credential | PSY.D.
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Telephone | 954-993-7638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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