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General NPI Number Information
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NPI Number | 1922862325
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Entity Type | Individual
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Provider Name | AMELIA JILL OFFERDAHL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1995 E OAKLAND PARK BLVD STE 310
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1138
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Country | US
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Telephone | 704-591-2920
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Fax |
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Provider Business Mailing Address
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Address Line | 1995 E OAKLAND PARK BLVD STE 310
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1138
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9119881
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-14161
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License Number State | NC
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