Healthcare Provider Details

I. General information

NPI: 1154019107
Provider Name (Legal Business Name): AMANDA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA ROWDEN

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 LONE OAK BLVD
NAPLES FL
34109-6834
US

IV. Provider business mailing address

6732 LONE OAK BLVD
NAPLES FL
34109-6834
US

V. Phone/Fax

Practice location:
  • Phone: 123-987-7773
  • Fax:
Mailing address:
  • Phone: 239-877-7734
  • Fax: 954-953-2771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: