Provider Demographics
NPI:1033852751
Name:ANCHETA, AMANDA DEL CARMEN (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DEL CARMEN
Last Name:ANCHETA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2612
Mailing Address - Country:US
Mailing Address - Phone:305-215-2986
Mailing Address - Fax:
Practice Address - Street 1:5701 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2612
Practice Address - Country:US
Practice Address - Phone:305-215-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9344313363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily