MEDICARE: FLORIDA ADVANCED MEDICAL SOLUTIONS

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	174400000X	Specialist

General Provider Information

NPI Number	:	1710750740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA ADVANCED MEDICAL SOLUTIONS

Provider Business Mailing Address
First Line	:	4099 TAMIAMI TRL N STE 403
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3548
Country	:	US
Telephone Number	:	239-455-0459
Fax Number	:

Provider Business Practice Location Address
First Line	:	4099 TAMIAMI TRL N STE 403
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3548
Country	:	US
Telephone Number	:	239-455-0459
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD HARRIS
Credential	:
Telephone Number	:	239-455-0459

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/01/2023

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