Healthcare Provider Details

I. General information

NPI: 1053395467
Provider Name (Legal Business Name): AMANDA BETH MYERS M.D., MSPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH ST S
ST PETERSBURG FL
33701-4630
US

IV. Provider business mailing address

PO BOX 2469
LOUISVILLE KY
40201-2469
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 502-852-8500
  • Fax: 502-852-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36957
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number36957
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME122063
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35.132313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: