MEDICARE: AMANDA PHILLIPS FNP-BC, PMHNP-BC

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	363LF0000X	Family Nurse Practitioner	APN0000013916	TN
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9329067	FL
3	363LF0000X	Family Nurse Practitioner	APRN9329067	FL

General Provider Information

NPI Number	:	1689813305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA PHILLIPS FNP-BC, PMHNP-BC

Provider Business Mailing Address
First Line	:	5821 S WILLIAMSON BLVD STE 204
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-6102
Country	:	US
Telephone Number	:	386-231-6325
Fax Number	:

Provider Business Practice Location Address
First Line	:	5821 S WILLIAMSON BLVD STE 204
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-6102
Country	:	US
Telephone Number	:	386-231-6325
Fax Number	:

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

Provider Enumeration Date	:	02/19/2009
Last Update Date	:	01/19/2026

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1912345042 — DR. KATHLEEN MARIE LUCKING D.D.S.
Practice Location Address:

5400 CORACI BLVD APT 6102
PORT ORANGE, FL
32128-7576

Practice Phone: 989-708-1384
Practice Fax:

1932540861 — MR. BENJAMIN MICHAEL ENSELL PA-C
Practice Location Address:

5821 S WILLIAMSON BLVD STE 202
PORT ORANGE, FL
32128-6102

Practice Phone: 386-231-6325
Practice Fax:

1063973733 — MRS. JENNA ROSE BONACCORSO DO
Practice Location Address:

5821 S WILLIAMSON BLVD STE 201
PORT ORANGE, FL
32128-6102

Practice Phone: 386-231-3420
Practice Fax: 386-231-3499

1467059790 — MRS. MIKALA PATRICIA HUGHES
Practice Location Address:

5821 S WILLIAMSON BLVD STE 204
PORT ORANGE, FL
32128-6102

Practice Phone: 386-231-6300
Practice Fax:

1932779535 — DR. DIANET FALCON DO
Practice Location Address:

5821 S WILLIAMSON BLVD STE 204
PORT ORANGE, FL
32128-6102

Practice Phone: 386-231-6300
Practice Fax: 386-322-6165

Directions to “ AMANDA PHILLIPS FNP-BC, PMHNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.