# ADVANCE AUTONOMOUS MEDICAL GROUP

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

## Provider details

- **NPI number:** 1972233815
- **Authorized official:** CARLOS ALBERTO LEON APRN (AUTONOMOUS NURSE PRACTITIONER)
- **Authorized official phone:** (786) 631-8382

## Contact information

- **Practice address:** 2103 RENAISSANCE BLVD APT 107, MIRAMAR, FL 33025-5691
- **Practice address phone:** (786) 631-8382
- **Mailing address:** 2103 RENAISSANCE BLVD APT 107, MIRAMAR, FL 33025-5691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2022
- **Last updated:** 03/13/2023