# AMA MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174834717
- **Authorized official:** DR. CRUZ MARTINA FANA-SOUCHET M.D. (PRESIDENT/MEDICAL DIRECTOR)
- **Authorized official phone:** (727) 331-8740

## Contact information

- **Practice address:** 125 PATRICIA AVE, UNITS B & D, DUNEDIN, FL 34698-8100
- **Practice address phone:** (727) 331-8740
- **Practice address fax:** (727) 331-8744
- **Mailing address:** PO BOX 306, PALM HARBOR, FL 34682-0306
- **Mailing address phone:** (727) 331-8740
- **Mailing address fax:** (727) 331-8744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME 96750 | FL | Yes |
| 207RI0200X | Infectious Disease Physician | ME 96750 | FL | — |

## Other

- **Enumeration date:** 06/29/2010
- **Last updated:** 11/06/2012