Provider Demographics
NPI:1417723305
Name:AMATO, MEGHAN A
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:A
Last Name:AMATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PINCKNEY DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3458
Mailing Address - Country:US
Mailing Address - Phone:305-431-5014
Mailing Address - Fax:
Practice Address - Street 1:3918 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4724
Practice Address - Country:US
Practice Address - Phone:813-232-3808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health