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NPI Code Detail

MEDICARE: MS. AMY L. WHITE PA-C

MEDICARE:  MS. AMY L. WHITE  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
1363A00000XPhysician AssistantC0003595MD
2363A00000XPhysician AssistantPA9110268FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2QAVJUOTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508832668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY L. WHITE PA-C
Provider Business Mailing Address
First Line : 1285 CREEKSIDE BLVD E UNIT 102
Second Line :
City : NAPLES
State : FL
Zip : 34109-0595
Country : US
Telephone Number : 239-624-0310
Fax Number : 239-624-0311
Provider Business Practice Location Address
First Line : 1285 CREEKSIDE BLVD E UNIT 102
Second Line :
City : NAPLES
State : FL
Zip : 34109-0595
Country : US
Telephone Number : 239-624-0310
Fax Number : 239-624-0311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 07/21/2022

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Directions to “ MS. AMY L. WHITE PA-C” Practice Location

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