Provider Demographics
NPI:1710194691
Name:ADVANCED MEDICAL CENTERS LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:DR
Authorized Official - First Name:F. CARTER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-908-5780
Mailing Address - Street 1:7900 103RD ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-6681
Mailing Address - Country:US
Mailing Address - Phone:904-908-5780
Mailing Address - Fax:904-908-5781
Practice Address - Street 1:7900 103RD ST
Practice Address - Street 2:SUITE 10
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6681
Practice Address - Country:US
Practice Address - Phone:904-908-5780
Practice Address - Fax:904-908-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty