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NPI Code Detail

MEDICARE: AMANDA JO DOWNEY MPH, RDN, LD/N, CLC

MEDICARE:   AMANDA JO DOWNEY  MPH, RDN, LD/N, CLC
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
1133V00000XRegistered DietitianND11458FL

General Provider Information

NPI Number : 1477240133
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JO DOWNEY MPH, RDN, LD/N, CLC
Provider Business Mailing Address
First Line : 1124 SW 45TH TER
Second Line :
City : CAPE CORAL
State : FL
Zip : 33914-6341
Country : US
Telephone Number : 402-432-6442
Fax Number :
Provider Business Practice Location Address
First Line : 160 N WACKER DR UNIT 201
Second Line :
City : CHICAGO
State : IL
Zip : 60606-1633
Country : US
Telephone Number : 239-255-6755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2023
Last Update Date : 06/01/2026

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