| Amp Group, Inc. | |
|
1411 Sw 22nd St Miami FL 33145-2876 | |
| (305) 204-9355 | |
| (305) 640-8034 |
| Full Name | Amp Group, Inc. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1411 Sw 22nd St, Miami, Florida |
| Authorized Official Name and Position | Lily Oquendo-ortiz (PRACTICE MANAGER) |
| Authorized Official Contact | 3052049355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amp Group, Inc. 1411 Sw 22nd St Miami FL 33145-2876 Ph: (305) 204-9355 | Amp Group, Inc. 1411 Sw 22nd St Miami FL 33145-2876 Ph: (305) 204-9355 |
| NPI Number | 1386092427 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 03/24/2025 |
| Certification Date | 03/24/2025 |
| Medicare PECOS PAC ID | 6305107558 |
|---|---|
| Medicare Enrollment ID | O20180302001618 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386092427 | NPI | - | NPPES |
| 108891900 | Medicaid | FL |
| Provider Name | Adrian L Mesa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386062305 PECOS PAC ID: 7113148933 Enrollment ID: I20141021000407 |
| Provider Name | Lorinda Lo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992276760 PECOS PAC ID: 9638402456 Enrollment ID: I20190611001799 |
| Provider Name | Siobhan Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447904248 PECOS PAC ID: 1951783133 Enrollment ID: I20220804001558 |
| Provider Name | Dianelys D Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336907591 PECOS PAC ID: 0941640114 Enrollment ID: I20240505000083 |
| Provider Name | Sandra Calzadilla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417088097 PECOS PAC ID: 9830622695 Enrollment ID: I20241031002601 |
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