Healthcare Provider Details

I. General information

NPI: 1215055736
Provider Name (Legal Business Name): AMY L THATCHER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18928 N DALE MABRY HWY STE 101
LUTZ FL
33548-4922
US

IV. Provider business mailing address

PO BOX 850001, DEPT 8340
ORLANDO FL
32885-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-909-1146
  • Fax: 813-909-4334
Mailing address:
  • Phone: 855-536-7277
  • Fax: 855-830-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP3413752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: