Advance Medical Specialty LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

OS10278 Issued in FL

Legal business name

ADVANCE MEDICAL SPECIALTY LLC

Practice address

8550 NE 138TH LN Ste 500
Lady Lake, FL 32159-6804

Phone

(352) 633-9858

Fax

(352) 633-9870

NPI assigned

Jul 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hemwattie S Jaimangal, DONPI 1821019001

Title

President

Phone

(352) 633-9858

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hemwattie S Jaimangal, DO

  • Infectious Disease Physician
  • Lady Lake, FL
  • NPI 1821019001
  Medicare reassignment Care Compare group NPD Authorized official
• Kelly Diaz-Vazquez, APRN

  • Nurse Practitioner
  • Lady Lake, FL
  • NPI 1972380590
  Medicare reassignment Care Compare group NPD
• Diane Ruth Kuehnlenz, RN, APN, CCNS

  • Family Nurse Practitioner
  • Lady Lake, FL
  • NPI 1649224585
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1114449345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18981 US HIGHWAY 441 STE 121",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576735",
            "telephone_number": "352-201-5949",
            "fax_number": "352-729-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 NE 138TH LN STE 500",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321596804",
            "telephone_number": "352-633-9858",
            "fax_number": "352-633-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL SPECIALTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "JAIMANGAL",
        "authorized_official_first_name": "HEMWATTIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-633-9858",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS10278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021679600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clarissa Rose Abrantes, MD
• Abu Azizullah MD PA
• Access Psych Care PLLC
• Pedro Adrover Lopez, M.D.
• Advanced Surgical and Medical Eye Care P a
• Advanced Therapeutics & Massage Inc
• Ajlal Ahmed, DMD
• Amarah Ahmed
• Erika Charrell Albertie-Young, LCSW

• Infectious Disease Physician in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.