Provider Demographics
NPI:1134418726
Name:THOMPSON, AMELIA BIANCA (MD)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:BIANCA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 E PRINCETON ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1469
Mailing Address - Country:US
Mailing Address - Phone:407-303-9194
Mailing Address - Fax:407-303-9273
Practice Address - Street 1:615 E PRINCETON ST STE 401
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1469
Practice Address - Country:US
Practice Address - Phone:407-303-9194
Practice Address - Fax:407-303-9273
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2017-008362080P0208X
FLME1443402080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases