Healthcare Provider Details

I. General information

NPI: 1003377029
Provider Name (Legal Business Name): AMANDA A CAPSANES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6290 LINTON BLVD STE 204
DELRAY BEACH FL
33484-6409
US

IV. Provider business mailing address

6290 LINTON BLVD STE 204
DELRAY BEACH FL
33484-6409
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-0299
  • Fax:
Mailing address:
  • Phone: 561-499-0299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11001197
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11001197
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: