MEDICARE: AMANDA MARIE DRAKOS PA-C

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	363A00000X	Physician Assistant	50.006722	OH

General Provider Information

NPI Number	:	1730732868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE DRAKOS PA-C

Provider Business Mailing Address
First Line	:	1951 W 26TH ST APT 205
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3462
Country	:	US
Telephone Number	:	248-719-4186
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 N CLEVELAND MASSILLON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-2200
Country	:	US
Telephone Number	:	330-668-6545
Fax Number	:

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

Provider Enumeration Date	:	07/17/2019
Last Update Date	:	03/30/2021

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