Provider Demographics
NPI:1760157648
Name:AMARILLO MEDICAL CENTER
Entity Type:Organization
Organization Name:AMARILLO MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-261-9628
Mailing Address - Street 1:8200 W 33RD AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5801
Mailing Address - Country:US
Mailing Address - Phone:786-261-9628
Mailing Address - Fax:305-827-5547
Practice Address - Street 1:8200 W 33RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5801
Practice Address - Country:US
Practice Address - Phone:786-261-9628
Practice Address - Fax:305-827-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health