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NPI Code Detail

MEDICARE: MS. AMY MICHELLE DELOACH APRN

MEDICARE: MS. AMY MICHELLE DELOACH APRN
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
1363LF0000XFamily Nurse Practitioner11042929FL
2163W00000XRegistered Nurse596983TX

General Provider Information

NPI Number : 1568922078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY MICHELLE DELOACH APRN
Provider Business Mailing Address
First Line : 7575 OSCEOLA POLK LINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33896-9112
Country : US
Telephone Number : 321-677-0531
Fax Number : 407-396-0158
Provider Business Practice Location Address
First Line : 7575 OSCEOLA POLK LINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33896-9112
Country : US
Telephone Number : 321-677-0531
Fax Number : 407-396-0158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2019
Last Update Date : 04/23/2026

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