Healthcare Provider Details

I. General information

NPI: 1568143824
Provider Name (Legal Business Name): AMANDA LUCIA VATURI DNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 07/28/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2171 PINE RIDGE RD
NAPLES FL
34109-2002
US

IV. Provider business mailing address

14647 TOPSAIL DR
NAPLES FL
34114-8695
US

V. Phone/Fax

Practice location:
  • Phone: 330-509-0511
  • Fax:
Mailing address:
  • Phone: 330-509-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11027285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: