Healthcare Provider Details

I. General information

NPI: 1063215077
Provider Name (Legal Business Name): AMANDA BAYERLEIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 311
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

180 JFK DR STE 311
ATLANTIS FL
33462-6641
US

V. Phone/Fax

Practice location:
  • Phone: 561-434-0353
  • Fax:
Mailing address:
  • Phone: 561-434-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11038351
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: