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General NPI Number Information
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NPI Number | 1073483822
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Entity Type | Organization
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Legal Business Name | MEDICAL ADVANCE PHARMA GROUP CORP
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 10531 BLOOMINGDALE RIDGE DR STE D
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City | RIVERVIEW
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State | FL
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Zip | 33578-5153
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Country | US
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Telephone | 888-613-5393
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Fax |
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Provider Business Mailing Address
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Address Line | 10531 BLOOMINGDALE RIDGE DR STE D
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City | RIVERVIEW
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State | FL
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Zip | 33578-5153
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Country | US
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Telephone | 888-613-5393
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ALBERT DEC
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Credential | DR
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Telephone | 888-613-5393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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