Provider Demographics
NPI:1912018755
Name:STEBBINS, AMANDA C (OD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:C
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7335 W SAND LAKE RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5538
Mailing Address - Country:US
Mailing Address - Phone:407-409-8123
Mailing Address - Fax:407-409-8124
Practice Address - Street 1:7335 W SAND LAKE RD
Practice Address - Street 2:SUITE 119
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5538
Practice Address - Country:US
Practice Address - Phone:407-409-8123
Practice Address - Fax:407-409-8124
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC004107152W00000X
CO2494152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist