Provider Demographics
NPI:1457660425
Name:APONICK, AMY UNDERWOOD (MPH, RD, LD/N, CDE)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:UNDERWOOD
Last Name:APONICK
Suffix:
Gender:F
Credentials:MPH, RD, LD/N, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 SW ARCHER RD
Mailing Address - Street 2:DIABETES CENTER OF EXCELLENCE, MEDICAL PLAZA
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1136
Mailing Address - Country:US
Mailing Address - Phone:352-265-0111
Mailing Address - Fax:352-265-8425
Practice Address - Street 1:2000 SW ARCHER RD
Practice Address - Street 2:DIABETES CENTER OF EXCELLENCE, MEDICAL PLAZA
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1136
Practice Address - Country:US
Practice Address - Phone:352-265-0111
Practice Address - Fax:352-265-8425
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered