MEDICARE: DR. AMANDA KING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AY1698	FL

General Provider Information

NPI Number	:	1447548953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA KING

Provider Business Mailing Address
First Line	:	310 S MACDILL AVE STE 202
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3489
Country	:	US
Telephone Number	:	813-876-8374
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 S MACDILL AVE STE 202
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3489
Country	:	US
Telephone Number	:	813-876-8374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2011
Last Update Date	:	05/25/2021

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Directions to “ DR. AMANDA KING ” Practice Location

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