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General NPI Number Information
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NPI Number | 1275018962
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Entity Type | Individual
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Provider Name | AMANDA LEWIS CONNORS PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 2290 10TH AVE N STE 101
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City | LAKE WORTH
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State | FL
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Zip | 33461-6609
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Country | US
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Telephone | 800-991-6117
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9120122
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 004281
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 004281
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 004281
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License Number State | CT
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