MEDICARE: AMANDA JANE CONTI 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	363L00000X	Nurse Practitioner	9308669	FL

General Provider Information

NPI Number	:	1912415217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA JANE CONTI ARNP

Provider Business Mailing Address
First Line	:	3106 W GRAY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1516
Country	:	US
Telephone Number	:	813-690-3709
Fax Number	:

Provider Business Practice Location Address
First Line	:	3106 W GRAY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1516
Country	:	US
Telephone Number	:	813-690-3709
Fax Number	:

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

Provider Enumeration Date	:	01/21/2018
Last Update Date	:	06/16/2018

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