Provider Demographics
NPI:1497581409
Name:SIMONE, AMANDA FAY (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FAY
Last Name:SIMONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:239-349-3539
Mailing Address - Fax:
Practice Address - Street 1:6900 DANIELS PKWY STE 23A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1586
Practice Address - Country:US
Practice Address - Phone:239-349-3539
Practice Address - Fax:239-208-3534
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035126363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner