Healthcare Provider Details

I. General information

NPI: 1316913239
Provider Name (Legal Business Name): AMANDA CARLENE LUCERO HANKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 W CENTER AVE
SEBRING FL
33870
US

IV. Provider business mailing address

131 W CENTER AVE
SEBRING FL
33870-3104
US

V. Phone/Fax

Practice location:
  • Phone: 863-658-1764
  • Fax: 855-847-7646
Mailing address:
  • Phone: 863-658-1764
  • Fax: 855-847-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2980082
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2980082
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN2980082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: