MEDICARE: AMANDA COLAS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	367500000X	Certified Registered Nurse Anesthetist	APRN11039973	FL

General Provider Information

NPI Number	:	1407378219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA COLAS

Provider Business Mailing Address
First Line	:	108 N 33RD CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 N 33RD CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6912
Country	:	US
Telephone Number	:	305-899-3288
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	06/06/2025

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Directions to “ AMANDA COLAS ” Practice Location

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