MEDICARE: MS. AMANDA STOLL MURPHY 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
1	363A00000X	Physician Assistant	MA051045	PA
2	363A00000X	Physician Assistant	OA002353	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RAILROAD MEDICARE	OTHER	PA	P00125664

General Provider Information

NPI Number	:	1073667861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA STOLL MURPHY PA-C

Provider Business Mailing Address
First Line	:	151 SOUTHHALL LN
Second Line	:	STE 300
City	:	MAITLAND
State	:	FL
Zip	:	32751-7172
Country	:	US
Telephone Number	:	407-875-2080
Fax Number	:	407-650-3455

Provider Business Practice Location Address
First Line	:	501 OFFICE CENTER DR
Second Line	:	SUITE 195
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-3220
Country	:	US
Telephone Number	:	215-836-7900
Fax Number	:	215-836-7900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	01/11/2017

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