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General NPI Number Information
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NPI Number | 1982164810
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Entity Type | Individual
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Provider Name | AMANDA DAVIS DORN DO
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 235 E PRINCETON ST STE 200
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City | ORLANDO
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State | FL
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Zip | 32804-5555
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Country | US
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Telephone | 407-303-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 PENSACOLA ST
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City | HONOLULU
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State | HI
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Zip | 96814-2118
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Country | US
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Telephone | 808-432-2000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DOS-2293
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | UO8854
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License Number State | FL
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