Healthcare Provider Details

I. General information

NPI: 1164219358
Provider Name (Legal Business Name): AMANDA DANIELLE STRONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 BOATNER RD STE 114
EGLIN AFB FL
32542-1302
US

IV. Provider business mailing address

EGLIN HOSPITAL/96 HCOS 307 BOATNER RD, SUITE 114
EGLIN AFB FL
32542
US

V. Phone/Fax

Practice location:
  • Phone: 850-883-8655
  • Fax:
Mailing address:
  • Phone: 850-883-8655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD0108084
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: