Healthcare Provider Details

I. General information

NPI: 1285425991
Provider Name (Legal Business Name): AMANDA RENEE O'CONNOR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SZARLIP

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE # 2346
STUART FL
34994-2346
US

IV. Provider business mailing address

12611 63RD LN N
WEST PALM BEACH FL
33412-2033
US

V. Phone/Fax

Practice location:
  • Phone: 561-339-0867
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11040550
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11040550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: