Provider Demographics
NPI:1184682205
Name:AMITY MEDICAL CORP
Entity Type:Organization
Organization Name:AMITY MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMEJO
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:305-642-0051
Mailing Address - Street 1:3305 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4103
Mailing Address - Country:US
Mailing Address - Phone:305-642-0051
Mailing Address - Fax:305-642-5294
Practice Address - Street 1:3305 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4103
Practice Address - Country:US
Practice Address - Phone:305-642-0051
Practice Address - Fax:305-642-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL822332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0230780001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER