Provider Demographics
NPI:1154829711
Name:AMARANTE, JOHANNA Y (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:Y
Last Name:AMARANTE
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6037 OSPREY LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3959
Mailing Address - Country:US
Mailing Address - Phone:813-444-3229
Mailing Address - Fax:
Practice Address - Street 1:8913 REGENTS PARK DR STE 620
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3077
Practice Address - Country:US
Practice Address - Phone:813-444-3229
Practice Address - Fax:813-444-3229
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management