Provider Demographics
NPI:1598794158
Name:AMOROSO, MICHAEL LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LOUIS
Last Name:AMOROSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2893
Mailing Address - Country:US
Mailing Address - Phone:941-357-1773
Mailing Address - Fax:941-256-7452
Practice Address - Street 1:2401 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2893
Practice Address - Country:US
Practice Address - Phone:941-357-1773
Practice Address - Fax:941-256-7452
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04142300208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ463818Medicare ID - Type Unspecified
NJC56326Medicare UPIN