Provider Demographics
NPI:1952508103
Name:DALY, AMY (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PARK CENTRAL BLVD S
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-2218
Mailing Address - Country:US
Mailing Address - Phone:954-691-0830
Mailing Address - Fax:
Practice Address - Street 1:1900 CORPORATE SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1941
Practice Address - Country:US
Practice Address - Phone:904-899-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2992472363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health