Provider Demographics
NPI:1780012120
Name:ALMEIDA, AMANDA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ALMEIDA
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 1:270 TIMBERBANK BLVD 20
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M1W2M1
Mailing Address - Country:CA
Mailing Address - Phone:647-458-5808
Mailing Address - Fax:
Practice Address - Street 1:81-964 HALEKI'I ST
Practice Address - Street 2:BLDG 4, SUITE C
Practice Address - City:KEALAKEKUA,
Practice Address - State:HAWAII
Practice Address - Zip Code:96750
Practice Address - Country:UM
Practice Address - Phone:808-339-7788
Practice Address - Fax:808-339-7736
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist