Ama Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AMA MEDICAL GROUP LLC

Doing business as

AMA MEDICAL GROUP OF LARGO

Practice address

1280 Missouri Ave N
Largo, FL 33770-1849

Phone

(727) 331-8740

NPI assigned

Jul 27, 2022

Organization subpart

Yes

Parent organization

AMA MEDICAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Cruz Martina Fana-Souchet, MD

Title

President

Phone

(727) 331-8740

Specialties & licenses 1

Addresses

Other names 1

• AMA MEDICAL GROUP OF LARGO Doing business as

Tax ID family

Ama Medical Group LLC3 organizations share this tax ID, including this one

Part of

Ama Medical Group LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ama Medical Group LLC

  • Non-Pharmacy Dispensing Site
  • Largo, FL
  • NPI 1174223416
  NPD tax ID
• Ama Medical Group LLC

  • Non-Pharmacy Dispensing Site
  • Dunedin, FL
  • NPI 1194431262
  NPD tax ID

Locations

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1629704176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 MISSOURI AVE N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337701849",
            "telephone_number": "727-331-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMA MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMA MEDICAL GROUP LLC",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "FANA-SOUCHET",
        "authorized_official_first_name": "CRUZ",
        "authorized_official_middle_name": "MARTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-331-8740",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMA MEDICAL GROUP OF LARGO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Largo, FL
• Providers in Largo, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.