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General NPI Number Information
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NPI Number | 1548908866
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Entity Type | Individual
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Provider Name | FADELA AMINE
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Gender | Female
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 11/23/2023
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Provider Practice Location Address
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Address Line | 17872 GILLETTE AVE STE 240
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City | IRVINE
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State | CA
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Zip | 92614-6573
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Country | US
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Telephone | 949-529-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 12612 CHALLENGER PKWY STE 365
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City | ORLANDO
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State | FL
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Zip | 32826-2784
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11020947
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 75661
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95028129
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License Number State | CA
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