Provider Demographics
NPI:1710750740
Name:FLORIDA ADVANCED MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:FLORIDA ADVANCED MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-455-0459
Mailing Address - Street 1:4099 TAMIAMI TRL N STE 403
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3548
Mailing Address - Country:US
Mailing Address - Phone:239-455-0459
Mailing Address - Fax:
Practice Address - Street 1:4099 TAMIAMI TRL N STE 403
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3548
Practice Address - Country:US
Practice Address - Phone:239-455-0459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty