Individual
MS. AMANDA K VAN VLIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7406 FULLERTON ST, JACKSONVILLE, FL 32256-3552
(904) 802-6800
(904) 249-9764
Mailing address
7406 FULLERTON ST STE 105, JACKSONVILLE, FL 32256-3588
(904) 802-6800
(904) 824-2353
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9343112
FL
Other
Enumeration date
12/10/2015
Last updated
03/17/2025
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