Provider Demographics
NPI:1235741141
Name:AMAT, LUIS V (APRN)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:V
Last Name:AMAT
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:38021 MARKET SQUARE DR
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7504
Practice Address - Country:US
Practice Address - Phone:813-715-0374
Practice Address - Fax:813-355-5090
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11008585363LF0000X
FLAPRN11008585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty