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General NPI Number Information
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NPI Number | 1265220610
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Entity Type | Individual
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Provider Name | AMANDA GAIL SMITH APRN
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Gender | Female
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 5216 CLAYTON CT
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City | FORT MYERS
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State | FL
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Zip | 33907-2116
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Country | US
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Telephone | 239-343-8260
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Fax | 239-343-4258
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-8260
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Fax | 239-343-4258
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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 | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | APRN11039119
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11039119
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License Number State | FL
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