Doctor Name: | AMANDA LEE STAPLETON |
NPI Number: | 1518303304 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA60867 |
Business Practice Address: | 115 E Granada Blvd Ste 1 Ormond Beach, FL - 321766634 |
Business Phone Number: | 3866775400 |
Business Fax Number: | 3866775420 |
Mailing Address: | 115 E Granada Blvd Ste 1, ORMOND BEACH |
State: | FL |
Postal Code: | 321766634 |
Phone Number: | 3866775400 |
Fax Number: | 3866775420 |
NPI Enumeration Date: | 05/20/2013 |
NPI Last Update Date: | 05/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA60867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |