MEDICARE: AMANDA BRILES

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	363LP2300X	Primary Care Nurse Practitioner	ARNP9323621	FL

General Provider Information

NPI Number	:	1780046821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA BRILES

Provider Business Mailing Address
First Line	:	6400 MANATEE AVE W
Second Line	:	SUITE A
City	:	BRADENTON
State	:	FL
Zip	:	34209-2378
Country	:	US
Telephone Number	:	941-761-8505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 S FORT HARRISON AVE
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3934
Country	:	US
Telephone Number	:	727-335-0400
Fax Number	:

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

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	07/15/2025

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Directions to “ AMANDA BRILES ” Practice Location

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