MEDICARE: AMPM RESEARCH CLINIC INC

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	261QR1100X	Research Clinic/Center

General Provider Information

NPI Number	:	1558737361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMPM RESEARCH CLINIC INC

Provider Business Mailing Address
First Line	:	17760 NW 2ND AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5013
Country	:	US
Telephone Number	:	305-999-3301
Fax Number	:	954-655-9971

Provider Business Practice Location Address
First Line	:	17760 NW 2ND AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5013
Country	:	US
Telephone Number	:	305-999-3301
Fax Number	:	954-655-9971

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ABEL MURILLO
Credential	:	MD
Telephone Number	:	305-999-3301

Provider Enumeration Date	:	08/16/2015
Last Update Date	:	08/16/2015

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