Provider Demographics
NPI:1336832252
Name:CINTRON, AMANDA ROSE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ROSE
Last Name:CINTRON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 SENANDER CRES
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-3726
Mailing Address - Country:US
Mailing Address - Phone:863-221-1135
Mailing Address - Fax:
Practice Address - Street 1:4813 SENANDER CRES
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-3726
Practice Address - Country:US
Practice Address - Phone:863-221-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5235965164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse