Provider Demographics
NPI:1669407938
Name:MEDLAND, AMANDA MARIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:MEDLAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:WOODRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9409 CANNON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-3147
Mailing Address - Country:US
Mailing Address - Phone:407-678-1413
Mailing Address - Fax:
Practice Address - Street 1:5201 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-8208
Practice Address - Country:US
Practice Address - Phone:407-629-1599
Practice Address - Fax:321-397-6716
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS390411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist