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General NPI Number Information
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NPI Number | 1417093493
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL CONCEPTS PSC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4 CALLE BALDORIOTY
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City | CIDRA
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State | PR
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Zip | 00739-3318
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Country | US
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Telephone | 787-739-3376
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Fax | 787-714-1134
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Provider Business Mailing Address
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Address Line | PO BOX 1802
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City | CIDRA
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State | PR
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Zip | 00739-1802
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Country | US
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Telephone | 787-739-3376
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Fax | 787-714-1134
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMAURY ARNALDO ROMAN
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Credential | M.D.
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Telephone | 787-739-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 057659
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4301087098
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5872
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License Number State | PR
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