Healthcare Provider Details

I. General information

NPI: 1235009796
Provider Name (Legal Business Name): AMANDA MUNI-MORGAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 49TH ST S
GULFPORT FL
33707-4301
US

IV. Provider business mailing address

1419 49TH ST S
GULFPORT FL
33707-4301
US

V. Phone/Fax

Practice location:
  • Phone: 727-346-8417
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: