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General NPI Number Information
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NPI Number | 1275872319
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Entity Type | Individual
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Provider Name | AMANDA MARCIANO PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 02/09/2013
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Last Update Date | 02/09/2013
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Provider Practice Location Address
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Address Line | 40079 HIGHWAY 27
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City | DAVENPORT
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State | FL
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Zip | 33837-7800
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Country | US
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Telephone | 863-547-3903
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 SIENA PARK BLVD W UNIT 104
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City | CELEBRATION
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State | FL
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Zip | 34747-4419
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Country | US
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Telephone | 305-790-1758
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS49119
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License Number State | FL
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