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General NPI Number Information
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NPI Number | 1790440782
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Entity Type | Individual
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Provider Name | AMANDA RENEE MENDOZA MSN, APRN, FNP
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Gender | Female
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 07/06/2025
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Provider Practice Location Address
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Address Line | 6890 N FLORIDA AVE
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City | HERNANDO
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State | FL
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Zip | 34442-3500
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Country | US
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Telephone | 352-534-6897
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Fax | 352-897-4333
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Provider Business Mailing Address
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Address Line | 973 N MARTHA CT
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City | MILFORD
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State | IL
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Zip | 60953-6079
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Country | US
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Telephone | 815-867-6242
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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 | APRN11015597
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License Number State | FL
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