MEDICARE: ACADEMY OF MEDICAL SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME 74724	FL
2	246YC3302X	Physician Office Based Coding Specialist
3	247100000X	Radiologic Technologist	RDMS 98631
4	2471S1302X	Sonography Radiologic Technologist	RDMS 98631
5	247200000X	Other Technician
6	246ZC0007X	Surgical Assistant	07-179

General Provider Information

NPI Number	:	1003085077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACADEMY OF MEDICAL SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	15450 NEW BARN RD
Second Line	:	SUIT 106
City	:	HIALEAH
State	:	FL
Zip	:	33014-2169
Country	:	US
Telephone Number	:	305-557-8303
Fax Number	:

Provider Business Practice Location Address
First Line	:	15450 NEW BARN RD
Second Line	:	SUIT 106
City	:	HIALEAH
State	:	FL
Zip	:	33014-2169
Country	:	US
Telephone Number	:	305-557-8303
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMALIA ROSALYN PINEDA
Credential	:	MD, SA-C
Telephone Number	:	305-557-8303

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	09/08/2008

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