Provider Demographics
NPI:1578531687
Name:FLOYD, AMBER NICOLE (INDEPENDENT DUTY COR)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:NICOLE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:INDEPENDENT DUTY COR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 TAUSSIG ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-3609
Mailing Address - Country:US
Mailing Address - Phone:858-577-9944
Mailing Address - Fax:858-577-9965
Practice Address - Street 1:BRANCH MEDICAL CLINIC MIRAMAR
Practice Address - Street 2:2496 MITCHNER WY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92145
Practice Address - Country:US
Practice Address - Phone:858-577-9944
Practice Address - Fax:858-577-9965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman