Provider Demographics
NPI:1386987584
Name:ADVANCED MEDICAL OF FLORIDA LLC
Entity type:Organization
Organization Name:ADVANCED MEDICAL OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMANPREET
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHATHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-408-5222
Mailing Address - Street 1:1528 LAKEVIEW RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3694
Mailing Address - Country:US
Mailing Address - Phone:727-408-5222
Mailing Address - Fax:727-408-5252
Practice Address - Street 1:1528 LAKEVIEW RD STE 150
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3694
Practice Address - Country:US
Practice Address - Phone:727-408-5222
Practice Address - Fax:724-408-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10839111N00000X
2081P2900X, 208VP0014X
FLPT30139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty