MEDICARE: CARA MARIE D'AMICO C-PNP, ARNP

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	363LP0200X	Pediatric Nurse Practitioner	ARNP9271693	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1528396678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA MARIE D'AMICO C-PNP, ARNP

Provider Business Mailing Address
First Line	:	P O BOX 1798
Second Line	:
City	:	MIDDLEBURG
State	:	FL
Zip	:	32050-1798
Country	:	US
Telephone Number	:	904-652-0870
Fax Number	:	904-652-2308

Provider Business Practice Location Address
First Line	:	10250 NORMANDY BLVD
Second Line	:	STE 201
City	:	JACKSONVILLE
State	:	FL
Zip	:	32221-8059
Country	:	US
Telephone Number	:	904-652-0870
Fax Number	:	904-652-2308

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

Provider Enumeration Date	:	12/01/2009
Last Update Date	:	08/24/2015

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