Provider Demographics
NPI:1003545930
Name:DELVALLE, AMANDA APRIL (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:APRIL
Last Name:DELVALLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 TUSCANY BAY DR APT 304
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1343
Mailing Address - Country:US
Mailing Address - Phone:787-464-2235
Mailing Address - Fax:
Practice Address - Street 1:4115 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1717
Practice Address - Country:US
Practice Address - Phone:727-376-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor