# AMANDA VICTORIA PUELLO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1326789454
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | APRN11018206 | FL | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | 11018206 | FL | — |

## Other

- **Enumeration date:** 04/05/2022
- **Last updated:** 04/21/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 113959100 | — | FL |
| 01 | — | YL20G | BLUE CROSS BLUE SHIELD | FL |