Provider Demographics
NPI:1568793545
Name:WANG, AMANDA (AP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8703 HASTINGS BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8817
Mailing Address - Country:US
Mailing Address - Phone:863-944-3986
Mailing Address - Fax:
Practice Address - Street 1:8703 HASTINGS BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8817
Practice Address - Country:US
Practice Address - Phone:863-944-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist