Healthcare Provider Details

I. General information

NPI: 1528876968
Provider Name (Legal Business Name): AMY WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2439 BEE RIDGE RD
SARASOTA FL
34239-6304
US

IV. Provider business mailing address

2681 MAPLELOFT LN
SARASOTA FL
34232-4379
US

V. Phone/Fax

Practice location:
  • Phone: 941-343-0609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN11036848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: