Provider Demographics
NPI:1477621019
Name:CAINES, AMITRA (MD)
Entity Type:Individual
Prefix:
First Name:AMITRA
Middle Name:
Last Name:CAINES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 OCOEE APOPKA RD STE 120
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9210
Mailing Address - Country:US
Mailing Address - Phone:407-889-1930
Mailing Address - Fax:407-889-1904
Practice Address - Street 1:2100 OCOEE APOPKA RD STE 120
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-9210
Practice Address - Country:US
Practice Address - Phone:407-889-1930
Practice Address - Fax:407-889-1904
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112725207R00000X, 207RC0000X, 207RI0011X
FLTRN9059207RC0000X
FLME102431207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology