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NPI Code Detail

MEDICARE: AMANDA DAVIS BENNETT DNP, NNP-BC

MEDICARE: AMANDA DAVIS BENNETT DNP, NNP-BC
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
1363L00000XNurse Practitioner277-000192IL
2363L00000XNurse Practitioner2632-033WI
3363LN0000XNeonatal Nurse PractitionerAPRN11025002FL

General Provider Information

NPI Number : 1265466783
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA DAVIS BENNETT DNP, NNP-BC
Provider Business Mailing Address
First Line : 2501 N ORANGE AVE STE 446
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4644
Country : US
Telephone Number : 813-467-4242
Fax Number : 813-467-4242
Provider Business Practice Location Address
First Line : 400 CELEBRATION PL
Second Line :
City : KISSIMMEE
State : FL
Zip : 34747-4970
Country : US
Telephone Number : 407-303-2528
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 06/19/2023

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