MEDICARE: AMANDA SENEA

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	171WH0202X	Home Modifications Contractor	CRC1329482	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	:	1962891424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA SENEA

Provider Business Mailing Address
First Line	:	18282 69TH DR
Second Line	:
City	:	MC ALPIN
State	:	FL
Zip	:	32062-2700
Country	:	US
Telephone Number	:	386-249-1640
Fax Number	:	386-364-1633

Provider Business Practice Location Address
First Line	:	18282 69TH DR
Second Line	:
City	:	MC ALPIN
State	:	FL
Zip	:	32062-2700
Country	:	US
Telephone Number	:	386-249-1640
Fax Number	:	386-364-1633

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

Provider Enumeration Date	:	01/21/2015
Last Update Date	:	01/21/2015

Similar Medicare Providers

1649692401 — SENEA CONSTRUCTION INC
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18282 69TH DR
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Practice Location Address:

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1407273220 — LIVE OAK PEST CONTROL, INC.
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Directions to “ AMANDA SENEA ” Practice Location

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