Provider Demographics
NPI:1174199657
Name:DILAURO, AMBER LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:DILAURO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 RUFFIN CIR SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6546
Mailing Address - Country:US
Mailing Address - Phone:860-597-1650
Mailing Address - Fax:
Practice Address - Street 1:206 E NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-4504
Practice Address - Country:US
Practice Address - Phone:860-597-1650
Practice Address - Fax:321-821-4955
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily