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NPI Code Detail

MEDICARE: AMANDA KATHERINE MCDONALD PA-C

MEDICARE:   AMANDA KATHERINE MCDONALD  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant9114083FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043803620
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA KATHERINE MCDONALD PA-C
Provider Business Mailing Address
First Line : 205 W HYDE PARK PL APT 309T
Second Line :
City : TAMPA
State : FL
Zip : 33606-2356
Country : US
Telephone Number : 239-963-5523
Fax Number :
Provider Business Practice Location Address
First Line : 5033 W LAUREL ST
Second Line :
City : TAMPA
State : FL
Zip : 33607-3855
Country : US
Telephone Number : 813-533-6439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2021
Last Update Date : 02/16/2021

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Directions to “ AMANDA KATHERINE MCDONALD PA-C” Practice Location

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