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General NPI Number Information
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NPI Number | 1063370989
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Entity Type | Individual
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Provider Name | AMANDA CHIKA CHIMA
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Gender | Male
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 11570 PANAMA CITY BEACH PKWY STE 100
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2523
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Country | US
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Telephone | 850-230-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 21325 ANNANDALE DR APT 98
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City | ROBERTSDALE
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State | AL
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Zip | 36567-6722
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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