Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | TRN26606 | FL |
N | 208600000X | Surgeon | TRN26606 | FL |
Y | 208800000X | Urologist | ME141601 | FL |
NPI | 1003304916 |
---|---|
Provider Name | Dr. Amanda Anne Myers |
First Address | Jacksonville, FL 32224-1865 |
Second Address | Jacksonville, FL 32224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 01/09/2020 |