Provider Demographics
NPI:1396570495
Name:TAPANES, AMANDA EMILY
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:EMILY
Last Name:TAPANES
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 1:6226 SW 165TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4483
Mailing Address - Country:US
Mailing Address - Phone:305-877-4464
Mailing Address - Fax:
Practice Address - Street 1:6226 SW 165TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-4483
Practice Address - Country:US
Practice Address - Phone:305-877-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily