Provider Demographics
NPI:1306294350
Name:AMOROS MEDICAL GROUP PA
Entity type:Organization
Organization Name:AMOROS MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOROS-MUJICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-542-3114
Mailing Address - Street 1:PO BOX 495009
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5009
Mailing Address - Country:US
Mailing Address - Phone:941-206-5200
Mailing Address - Fax:941-206-3322
Practice Address - Street 1:3527 TAMIAMI TRL
Practice Address - Street 2:UNIT E
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8128
Practice Address - Country:US
Practice Address - Phone:941-206-5200
Practice Address - Fax:941-206-3322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty