Provider Demographics
NPI:1386142446
Name:ADVANCED MEDICAL PRACTICE LLC
Entity type:Organization
Organization Name:ADVANCED MEDICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITCHER-SPECK
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:772-370-1140
Mailing Address - Street 1:100 S CARDINAL PL
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34945-3482
Mailing Address - Country:US
Mailing Address - Phone:772-370-1140
Mailing Address - Fax:
Practice Address - Street 1:100 S CARDINAL PL
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34945-3482
Practice Address - Country:US
Practice Address - Phone:772-370-1140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty