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Organization
ADVANCED MEDICAL PROVIDER INC
Active
Organization
ADVANCED MEDICAL PROVIDER INC
Active
Other names
ADVANCED MEDICAL PROVIDERS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSY MADHUKAR NP (PRESIDENT)
(954) 600-8994
Entity
Organization
Contact information
Practice address
1560 SAWGRASS CORPORATE PKWY FL 4, SUNRISE, FL 33323-2855
(954) 600-8994
Mailing address
11510 SW 2ND ST, PLANTATION, FL 33325-2922
(954) 600-8994
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
NULL
171000000X
Military Health Care Provider
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
302F00000X
Exclusive Provider Organization
—
NULL
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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