AMA MEDICAL GROUP LLC – Internal Medicine Physician, NPI 1174834717

AMA MEDICAL GROUP LLC is a healthcare provider. based in Palm harbor, Florida. specializing in Internal Medicine Physician. The organization holds a License No. ME 96750 (FL). The NPI Number for AMA MEDICAL GROUP LLC is 1174834717

Main info

Organization
Name
AMA MEDICAL GROUP LLC
NPI
1174834717
Phone
(727) 331-8740
Address
PO BOX 306
Authorized Official
DR. CRUZ MARTINA FANA-SOUCHET PRESIDENT/MEDICAL DIRECTOR M.D.
Enumeration Date
29 June 2010
Last Update Date
6 November 2012
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for AMA MEDICAL GROUP LLC

  • PO BOX 306

    PALM HARBOR, FL 346820306

    Phone: (727) 331-8740

    Fax: (727) 331-8744

    Type: Mailing

  • 125 PATRICIA AVE

    UNITS B & D

    DUNEDIN, FL 346988100

    Phone: (727) 331-8740

    Fax: (727) 331-8744

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-09-30 (252 days ago).

Enrollment records

1

Earliest due date

2025-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20110311000533OClinic/Group PracticeFL2025-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34682)

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Reviews

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Frequently asked questions

What NPI should I save for AMA MEDICAL GROUP LLC?
Save NPI 1174834717 if you need a stable reference for AMA MEDICAL GROUP LLC.
Does this profile mean AMA MEDICAL GROUP LLC is currently active?
Yes — AMA MEDICAL GROUP LLC appears active in the national provider directory.
Does AMA MEDICAL GROUP LLC list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for AMA MEDICAL GROUP LLC. Clinical services aligned with this taxonomy classification.
Where does public data place AMA MEDICAL GROUP LLC?
The snapshot lists Palm Harbor, Florida for AMA MEDICAL GROUP LLC; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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