Healthcare Provider Details

I. General information

NPI: 1255241402
Provider Name (Legal Business Name): AMANDA VALERIE LOUZON LDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14951 STERLING OAKS DR
NAPLES FL
34110-4104
US

IV. Provider business mailing address

14951 STERLING OAKS DR
NAPLES FL
34110-4104
US

V. Phone/Fax

Practice location:
  • Phone: 239-206-0147
  • Fax:
Mailing address:
  • Phone: 239-206-0147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number8512
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: