Healthcare Provider Details

I. General information

NPI: 1356608954
Provider Name (Legal Business Name): AMANDA R SCHLEFMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH ST S STE 504
ST PETERSBURG FL
33701-4804
US

IV. Provider business mailing address

601 5TH ST S STE 504
ST PETERSBURG FL
33701-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-7438
  • Fax: 727-767-8270
Mailing address:
  • Phone: 727-767-7438
  • Fax: 727-767-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC2-0011975
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberOS15291
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: