Healthcare Provider Details

I. General information

NPI: 1376864264
Provider Name (Legal Business Name): AMANDA BRYN LEE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA BRYN LEWIS ARNP

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12280 US HIGHWAY 301 N
PARRISH FL
34219-8658
US

IV. Provider business mailing address

6600 UNIVERSITY PKWY STE 301
LAKEWOOD RANCH FL
34240-9048
US

V. Phone/Fax

Practice location:
  • Phone: 941-361-1100
  • Fax:
Mailing address:
  • Phone: 941-361-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9190072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: