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General NPI Number Information
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NPI Number | 1407307911
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE PERINATAL CONSULTANTS LLC
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 2418 E PLAZA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5301
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Country | US
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Telephone | 850-727-8450
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Fax | 850-765-8674
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Provider Business Mailing Address
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Address Line | PO BOX 13506
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City | TALLAHASSEE
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State | FL
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Zip | 32317-3506
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Country | US
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Telephone | 850-219-0011
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Fax | 850-219-0077
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADANNA C AMANZE
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Credential | MD
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Telephone | 505-506-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | ME126672
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License Number State | FL
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